FMC SBHC - BROOKE COMPLEX
NPI 1063918472
Clinic/Center - Federally Qualified Health Center (FQHC) in Wellsburg, WV
NPI Status: Active since April 04, 2018
Contact Information
29 BRUIN DR
WELLSBURG, WV
ZIP 26070
Phone: (047) 977-7333
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- Accepts Insurance
- CLIA Number: 36D2055383
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 03-10-2027
About FMC SBHC - BROOKE COMPLEX
This page provides the complete NPI Profile along with additional information for Fmc Sbhc - Brooke Complex, a primary care provider established in Wellsburg, West Virginia operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1063918472 assigned on April 2018. The practitioner's primary taxonomy code is 261QF0400X with license number 2271-6959 (WV). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Fmc Sbhc - Brooke Complex. The authorized official of this NPI record is Judy L Raveaux (Ceo)
- NPI
- 1063918472
- Provider Legal Name
- CHANGE INCORPORATED
- Other Organization Name
- FMC SBHC - BROOKE COMPLEX
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 29 BRUIN DR WELLSBURG, WV 26070
- Location Phone
- (047) 977-7333
- Mailing Address
- 3158 WEST ST WEIRTON, WV 26062
- Mailing Phone
- (130) 479-7773
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 04-04-2018
- Last Update Date
- 04-04-2018
- Code Navigator
A primary care provider (PCP) like Fmc Sbhc - Brooke Complex 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 Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
- License No.
- 2271-6959
- License State
- WV
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 7500 $25 Generic Drugs - HMO
- Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Gold 2000 $15 Generic Drugs - HMO
- Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
- Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
- Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
- Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Low Deductible Silver 5000 $3 Generic Drugs - HMO
- Low Deductible Silver 5000 $3 Generic Drugs + Adult Vision & Fitness - HMO
- Low Premium Bronze 10600 $25 Generic Drugs - HMO
- Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
- Low Premium Silver 6200 $3 Generic Drugs - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 36D2055383
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- March 11, 2025
- Certificate Expiration Date
- March 10, 2027
- Laboratory Director
- KELLI FOURNIER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fmc Sbhc - Brooke Complex 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 1063918472, 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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
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.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063918472, enumerated as an "organization" on April 04, 2018.
The provider is located at 29 BRUIN DR WELLSBURG, WV 26070 and the phone number is (047) 977-7333.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
The provider might be accepting Accepts: CareSource. Please consult your insurance carrier or call the provider to verify.
