PICKENS COUNTY PRIMARY CARE, P.C
NPI 1063988806
Clinic/Center - Rural Health in Gordo, AL

NPI Status: Active since October 19, 2018

Contact Information

630 4TH ST NW
GORDO, AL
ZIP 35466
Phone: (205) 375-6251
Fax: (205) 375-9064

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  • Organization
  • Clinic/Center
  • Rural Health
  • CLIA Number: 01D2197746
  • CLIA Cert. Type: Waiver
  • CLIA Exp. Date: 10-26-2024

About PICKENS COUNTY PRIMARY CARE, P.C

Pickens County Primary Care, P.c is a primary care provider established in Gordo, Alabama operating as a Clinic/center with a focus in rural health . The healthcare provider is registered in the NPI registry with number 1063988806 assigned on October 2018. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Julia L Boothe Md (Owner)

NPI
1063988806
Provider Name
PICKENS COUNTY PRIMARY CARE, P.C
Entity Type
Organization
Location Address
630 4TH ST NW GORDO, AL 35466
Location Phone
(205) 375-6251
Location Fax
(205) 375-9064
Mailing Address
108 4TH AVE SW STE A REFORM, AL 35481
Mailing Phone
(205) 375-6251
Mailing Fax
(205) 375-9064
Is Sole Proprietor?
N/A
Is Organization Subpart?
Yes
Enumeration Date
10-19-2018
Last Update Date
02-19-2020
Code Navigator

A primary care provider (PCP) like Pickens County Primary Care, P.c 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 .

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

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

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

JULIA L BOOTHE MD

Authorized Official Title
OWNER
Authorized Official Phone
(205) 792-6701

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
01D2197746
Facility Type
Rural Health Clinic
Certificate Effective Date
October 27, 2022
Certificate Expiration Date
October 26, 2024
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pickens County Primary Care, 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 Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1063988806
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
201231881680
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 2 + 3 + 1 + 8 + 8 + 1 + 6 + 8 + 0 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1063988806 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063988806, enumerated in the NPI registry as an "organization" on October 19, 2018

The provider is located at 630 4th St Nw Gordo, Al 35466 and the phone number is (205) 375-6251

This medical organization specializes in Clinic/Center with taxonomy code 261QR1300X with a focus in Rural Health

The provider's CLIA number is 01D2197746 for a "rural health clinic" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..

This NPI record was last updated on October 19, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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