CALLAHAN MC, LLC
NPI 1073139721
Assisted Living Facility in Roseburg, OR

NPI Status: Active since June 18, 2020

Contact Information

1770 NW VALLEY VIEW DR
ROSEBURG, OR
ZIP 97471
Phone: (541) 673-3900
Fax: (541) 673-3105

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 38D2149997
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 06-13-2026

About CALLAHAN MC, LLC

This page provides the complete NPI Profile along with additional information for Callahan Mc, Llc, a provider established in Roseburg, Oregon operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1073139721 assigned on June 2020. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Gregory A. Roderick (Member)

NPI
1073139721
Provider Name
CALLAHAN MC, LLC
Entity Type
Organization
Location Address
1770 NW VALLEY VIEW DR ROSEBURG, OR 97471
Location Phone
(541) 673-3900
Location Fax
(541) 673-3105
Mailing Address
7420 SW BRIDGEPORT RD STE 105 PORTLAND, OR 97224
Mailing Phone
(503) 597-4906
Mailing Fax
(541) 673-3105
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-18-2020
Last Update Date
06-18-2020
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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

GREGORY A. RODERICK

Authorized Official Title
MEMBER
Authorized Official Phone
(503) 443-1818

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
520099MEDICAID (05)OR 

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
38D2149997
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
June 14, 2024
Certificate Expiration Date
June 13, 2026
Laboratory Director
KIM JORDAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Callahan Mc, 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 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.
1073139721
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20143231874
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 4 + 3 + 2 + 3 + 1 + 8 + 7 + 4 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1073139721 is valid because the calculated check digit 1 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 1073139721, enumerated as an "organization" on June 18, 2020.

The provider is located at 1770 NW VALLEY VIEW DR ROSEBURG, OR 97471 and the phone number is (541) 673-3900.

Assisted Living Facility with taxonomy code 310400000X.

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