CCG MANAGEMENT, LLC
NPI 1063942563
Lodging in Baltimore, MD
NPI Status: Active since June 16, 2017
Contact Information
420 E LORRAINE AVE
BALTIMORE, MD
ZIP 21218
Phone: (410) 617-0142
Fax: (443) 873-6975
- Organization
- Lodging
- CLIA Number: 21D2144124
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 02-11-2028
About CCG MANAGEMENT, LLC
This page provides the complete NPI Profile along with additional information for Ccg Management, Llc, a provider established in Baltimore, Maryland operating as a Lodging. The healthcare provider is registered in the NPI registry with number 1063942563 assigned on June 2017. The practitioner's primary taxonomy code is 177F00000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Ccg Management, Llc. The authorized official of this NPI record is Barbara Wahl Rn, Ma (Coo)
- NPI
- 1063942563
- Provider Legal Name
- CONCERTED CARE GROUP MANAGEMENT LLC
- Other Organization Name
- CCG MANAGEMENT, LLC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 420 E LORRAINE AVE BALTIMORE, MD 21218
- Location Phone
- (410) 617-0142
- Location Fax
- (443) 873-6975
- Mailing Address
- 428 E 25TH ST BALTIMORE, MD 21218
- Mailing Phone
- (410) 617-0142
- Mailing Fax
- (443) 873-6975
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-16-2017
- Last Update Date
- 06-16-2017
- Code Navigator
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
Lodging
- Taxonomy Code
- 177F00000X
- Type
- Other Service Providers
- Taxonomy Description
- A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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
- 21D2144124
- Facility Type
- Community Clinic
- Certificate Effective Date
- February 12, 2026
- Certificate Expiration Date
- February 11, 2028
- Laboratory Director
- ERIKA KANE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ccg Management, Llc 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 1063942563, 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.
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 57 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063942563, enumerated as an "organization" on June 16, 2017.
The provider is located at 420 E LORRAINE AVE BALTIMORE, MD 21218 and the phone number is (410) 617-0142.
Lodging with taxonomy code 177F00000X.
