PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
NPI 1063188472
Clinic/Center - Multi-Specialty in Cleveland, NC

NPI Status: Active since August 17, 2021

Contact Information

11550 STATESVILLE BLVD
CLEVELAND, NC
ZIP 27013
Phone: (704) 645-5997

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  • Organization
  • Clinic/Center
  • Multi-Specialty
  • CLIA Number: 34D2093511
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-29-2027

About PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C

This page provides the complete NPI Profile along with additional information for Premise Health Of North Carolina Medical, P.c, a provider established in Cleveland, North Carolina operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1063188472 assigned on August 2021. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's former legal business name is Chs North Carolina Medical Pc. The authorized official of this NPI record is Jonathan B Leizman Md (President)

NPI
1063188472
Provider Legal Name
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Other Organization Name
CHS NORTH CAROLINA MEDICAL PC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
11550 STATESVILLE BLVD CLEVELAND, NC 27013
Location Phone
(704) 645-5997
Mailing Address
5500 MARYLAND WAY BRENTWOOD, TN 37027
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-17-2021
Last Update Date
10-09-2022
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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

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

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

JONATHAN B LEIZMAN MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(216) 479-9063

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
34D2093511
Facility Type
Physician Office
Certificate Effective Date
March 30, 2025
Certificate Expiration Date
March 29, 2027
Laboratory Director
JACQUELINE ZINN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Premise Health Of North Carolina Medical, P.c to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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 1063188472, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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
6
Doubled → 12 → 1 + 2
Pos 4
3
Unchanged
Pos 5
1
Doubled → 2
Pos 6
8
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
4
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
2
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 6 → 12 → 3 1 → 2 8 → 16 → 7 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 + 2 + 3 + 2 + 8 + 1 + 6 + 4 + 1 + 4 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1063188472.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center (Multi-Specialty)
11550 STATESVILLE BLVD
CLEVELAND, NC 27013

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063188472, enumerated as an "organization" on August 17, 2021.

The provider is located at 11550 STATESVILLE BLVD CLEVELAND, NC 27013 and the phone number is (704) 645-5997.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.