DESERT PAVILION SKILLED NURSING FACILITY
NPI 1053483040
Skilled Nursing Facility in Casa Grande, AZ

NPI Status: Active since November 14, 2006

Contact Information

950 N ARIZOLA RD
CASA GRANDE, AZ
ZIP 85222
Phone: (520) 381-6650

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 03D1017071
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 05-22-2026

About DESERT PAVILION SKILLED NURSING FACILITY

This page provides the complete NPI Profile along with additional information for Desert Pavilion Skilled Nursing Facility, a provider established in Casa Grande, Arizona operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1053483040 assigned on November 2006. The practitioner's primary taxonomy code is 314000000X with license number NCI-352 (AZ). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Desert Pavilion Skilled Nursing Facility. The authorized official of this NPI record is Mr. John Marty Dernier (Ceo)

NPI
1053483040
Provider Legal Name
CASA GRANDE COMMUNITY HOSPITAL
Other Organization Name
DESERT PAVILION SKILLED NURSING FACILITY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
950 N ARIZOLA RD CASA GRANDE, AZ 85222
Location Phone
(520) 381-6650
Mailing Address
950 N ARIZOLA RD CASA GRANDE, AZ 85222
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-14-2006
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
NCI-352
License State
AZ
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. JOHN MARTY DERNIER

Authorized Official Title
CEO
Authorized Official Phone
(520) 381-6453

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
03D1017071
Facility Type
Community Clinic
Certificate Effective Date
September 16, 2003
Certificate Expiration Date
May 22, 2026
Laboratory Director
JAMES KLUTTS
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Desert Pavilion Skilled Nursing Facility on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053483040, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
8
Unchanged
Pos 7
3
Doubled → 6
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 4 → 8 3 → 6 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 8 + 8 + 6 + 0 + 8 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1053483040.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Rehabilitation Unit
950 N ARIZOLA RD
CASA GRANDE, AZ 85222
Psychiatric Unit
950 N ARIZOLA RD
CASA GRANDE, AZ 85222

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053483040, enumerated as an "organization" on November 14, 2006.

The provider is located at 950 N ARIZOLA RD CASA GRANDE, AZ 85222 and the phone number is (520) 381-6650.

Skilled Nursing Facility with taxonomy code 314000000X.