CAROLINA SPECIALTY CARE,PA
NPI 1063559193
Legal Medicine in Statesville, NC

NPI Status: Active since January 30, 2007

Contact Information

124 SUNSET HILL DR
STATESVILLE, NC
ZIP 28625
Phone: (704) 872-8711
Fax: (704) 872-5866

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  • Organization
  • Legal Medicine
  • CLIA Number: 34D0933009
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-10-2026

About CAROLINA SPECIALTY CARE,PA

This page provides the complete NPI Profile along with additional information for Carolina Specialty Care,pa, a provider established in Statesville, North Carolina operating as a Legal Medicine. The healthcare provider is registered in the NPI registry with number 1063559193 assigned on January 2007. The practitioner's primary taxonomy code is 173000000X with license number 930036 (NC). The provider is registered as an organization and their NPI record was last updated 17 years ago. Carolina Specialty Care,pa operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Robert I Wodecki Md (Vice -president)

NPI
1063559193
Provider Name
CAROLINA SPECIALTY CARE,PA
Entity Type
Organization
Location Address
124 SUNSET HILL DR STATESVILLE, NC 28625
Location Phone
(704) 872-8711
Location Fax
(704) 872-5866
Mailing Address
124 SUNSET HILL RD STATESVILLE, NC 28625
Mailing Phone
(704) 872-8711
Mailing Fax
(704) 872-5866
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-30-2007
Last Update Date
07-16-2009
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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

Legal Medicine

Taxonomy Code
173000000X
Type
Other Service Providers
License No.
930036
License State
NC
Taxonomy Description
The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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. ROBERT I WODECKI MD

Authorized Official Title
VICE -PRESIDENT
Authorized Official Phone
(704) 872-8711

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
89016CPMEDICAID (05)NC 
2334530MEDICARE PIN (08)NC 
4980030002MEDICARE NSC (07)NC 
89014TMMEDICAID (05)NC 

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
34D0933009
Facility Type
Physician Office
Certificate Effective Date
June 11, 2024
Certificate Expiration Date
June 10, 2026
Laboratory Director
DR. DOUGLAS RABURN
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Carolina Specialty Care,pa 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 1063559193, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

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
5
Doubled → 10 → 1 + 0
Pos 6
5
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
3
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 5 → 10 → 1 9 → 18 → 9 9 → 18 → 9

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 + 1 + 0 + 5 + 1 + 8 + 1 + 1 + 8 + 24 = 57

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

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1063559193.

Other Providers at the Same Location


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

Legal Medicine
124 SUNSET HILL DR
STATESVILLE, NC 28625

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063559193, enumerated as an "organization" on January 30, 2007.

The provider is located at 124 SUNSET HILL DR STATESVILLE, NC 28625 and the phone number is (704) 872-8711.

Legal Medicine with taxonomy code 173000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.