JORDAN VALLEY DERMATOLOGY
NPI 1073954913
Specialist in Casper, WY

NPI Status: Active since July 08, 2013

Contact Information

428 S DURBIN ST STE 103
CASPER, WY
ZIP 82601
Phone: (307) 234-0003
Fax: (307) 265-6575

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  • Organization
  • Specialist
  • CLIA Number: 53D2092856
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-15-2027

About JORDAN VALLEY DERMATOLOGY

This page provides the complete NPI Profile along with additional information for Jordan Valley Dermatology, a provider established in Casper, Wyoming operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1073954913 assigned on July 2013. The practitioner's primary taxonomy code is 174400000X with license number 8624096-4405 (UT). The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's former legal business name is Jordan Valley Dermatology. The authorized official of this NPI record is Virginia Louise Tubbs Np (Owner)

NPI
1073954913
Provider Legal Name
JORDAN VALLEY DERMATOLOGY
Other Organization Name
JORDAN VALLEY DERMATOLOGY
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
428 S DURBIN ST STE 103 CASPER, WY 82601
Location Phone
(307) 234-0003
Location Fax
(307) 265-6575
Mailing Address
428 S DURBIN ST STE 103 CASPER, WY 82601
Mailing Phone
(307) 234-0003
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-08-2013
Last Update Date
06-21-2019
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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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
8624096-4405
License State
UT
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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

VIRGINIA LOUISE TUBBS NP

Authorized Official Title
OWNER
Authorized Official Phone
(307) 265-2936

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
53D2092856
Facility Type
Physician Office
Certificate Effective Date
March 16, 2025
Certificate Expiration Date
March 15, 2027
Laboratory Director
VIRGINIA L. TUBBS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Jordan Valley Dermatology 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 1073954913, 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 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
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
5
Unchanged
Pos 7
4
Doubled → 8
Pos 8
9
Unchanged
Pos 9
1
Doubled → 2
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 7 → 14 → 5 9 → 18 → 9 4 → 8 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 1 + 8 + 5 + 8 + 9 + 2 + 24 = 67

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

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1073954913.

Other Providers at the Same Location


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

Nurse Practitioner (Family)
428 S DURBIN ST STE 103
CASPER, WY 82601

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073954913, enumerated as an "organization" on July 08, 2013.

The provider is located at 428 S DURBIN ST STE 103 CASPER, WY 82601 and the phone number is (307) 234-0003.

Specialist with taxonomy code 174400000X.