UPPER LAKE CLINIC RHC
NPI 1053495879
Clinic/Center - Rural Health in Lakeport, CA

NPI Status: Active since October 25, 2006

Contact Information

5176 HILL RD E
LAKEPORT, CA
ZIP 95453
Phone: (707) 262-5001
Fax: (707) 262-5006

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  • Organization
  • Clinic/Center
  • Rural Health
  • CLIA Number: 05D0612179
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 11-30-2026

About UPPER LAKE CLINIC RHC

This page provides the complete NPI Profile along with additional information for Upper Lake Clinic Rhc, a primary care provider established in Lakeport, California operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1053495879 assigned on October 2006. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's other name is Upper Lake Clinic Rhc. The authorized official of this NPI record is Kelly Mather (Ceo)

NPI
1053495879
Provider Legal Name
SUTTER LAKESIDE HOSPITAL
Other Organization Name
UPPER LAKE CLINIC RHC
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
5176 HILL RD E LAKEPORT, CA 95453
Location Phone
(707) 262-5001
Location Fax
(707) 262-5006
Mailing Address
5176 HILL RD E LAKEPORT, CA 95453
Mailing Phone
(707) 262-5001
Mailing Fax
(707) 262-5006
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-25-2006
Last Update Date
08-22-2020
Code Navigator

A primary care provider (PCP) like Upper Lake Clinic Rhc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

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

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities
License State
CA

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

KELLY MATHER

Authorized Official Title
CEO
Authorized Official Phone
(707) 262-5001

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
05D0612179
Facility Type
Hospital
Certificate Effective Date
December 01, 2024
Certificate Expiration Date
November 30, 2026
Laboratory Director
JUDY DOYLE
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Upper Lake Clinic Rhc 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 1053495879, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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
9
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
8
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
9
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 5 → 10 → 1 7 → 14 → 5

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 + 9 + 1 + 0 + 8 + 1 + 4 + 24 = 61

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

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1053495879.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

General Acute Care Hospital (Rural)
5176 HILL RD E
LAKEPORT, CA 95453
Emergency Medicine
5176 HILL RD E, EMERGENCY DEPARTMENT
LAKEPORT, CA 95453
Radiology (Diagnostic Radiology)
5176 HILL RD E
LAKEPORT, CA 95453
Medicare Defined Swing Bed Unit
5176 HILL RD E
LAKEPORT, CA 95453
Clinic/Center (Rural Health)
5176 HILL RD E
LAKEPORT, CA 95453
Internal Medicine
5176 HILL RD E
LAKEPORT, CA 95453
Anesthesiology
5176 HILL RD E
LAKEPORT, CA 95453
Marriage & Family Therapist
5176 HILL RD E, WELLNESS CENTER, SUTTER LAKESIDE HOS
LAKEPORT, CA 95453
Clinical Medical Laboratory
5176 HILL RD E
LAKEPORT, CA 95453
Anesthesiology
5176 HILL RD E
LAKEPORT, CA 95453
Dietitian, Registered
5176 HILL RD E
LAKEPORT, CA 95453
Clinic/Center (Rural Health)
5176 HILL RD E
LAKEPORT, CA 95453
Acupuncturist
5176 HILL RD E
LAKEPORT, CA 95453
Anesthesiology
5176 HILL RD E
LAKEPORT, CA 95453
Pathology (Clinical Pathology/Laboratory Medicine)
5176 HILL RD E
LAKEPORT, CA 95453
Radiology (Diagnostic Radiology)
5176 HILL RD E, DEPT OF IMAGING
LAKEPORT, CA 95453
Emergency Medicine
5176 HILL RD E
LAKEPORT, CA 95453
Anesthesiology
5176 HILL RD E
LAKEPORT, CA 95453
Radiology (Diagnostic Radiology)
5176 HILL RD E
LAKEPORT, CA 95453
Emergency Medicine
5176 HILL RD E
LAKEPORT, CA 95453

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053495879, enumerated as an "organization" on October 25, 2006.

The provider is located at 5176 HILL RD E LAKEPORT, CA 95453 and the phone number is (707) 262-5001.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.