THOMAS S DECATUR HOME
NPI 1083056782
Intermediate Care Facility, Intellectual Disabilities in Fayetteville, NC
NPI Status: Active since July 23, 2013
Contact Information
7559 DECATUR DR
FAYETTEVILLE, NC
ZIP 28303
Phone: (910) 484-3717
Fax: (910) 484-1315
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 34D2271409
- CLIA Cert. Type: Other - GROUP HOME
- CLIA Exp. Date: 11-01-2026
About THOMAS S DECATUR HOME
This page provides the complete NPI Profile along with additional information for Thomas S Decatur Home, a provider established in Fayetteville, North Carolina operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1083056782 assigned on July 2013. The practitioner's primary taxonomy code is 315P00000X with license number MHL-026-944 (NC). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's is doing business as Thomas S Decatur Home. The authorized official of this NPI record is Sera Gilmore (Administrator)
- NPI
- 1083056782
- Provider Legal Name
- MID-STATE HEALTH SYSTEMS, INC
- Other Organization Name
- THOMAS S DECATUR HOME
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 7559 DECATUR DR FAYETTEVILLE, NC 28303
- Location Phone
- (910) 484-3717
- Location Fax
- (910) 484-1315
- Mailing Address
- 3721 LEGION RD HOPE MILLS, NC 28348
- Mailing Phone
- (910) 484-3717
- Mailing Fax
- (910) 484-1315
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-23-2013
- Last Update Date
- 12-07-2015
- 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
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- MHL-026-944
- License State
- NC
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
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
- 34D2271409
- Facility Type
- Other - GROUP HOME
- Certificate Effective Date
- November 02, 2024
- Certificate Expiration Date
- November 01, 2026
- Laboratory Director
- CHERYL G. MATHEWS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Thomas S Decatur Home 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 1083056782, 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 2 providers are registered at the same or a nearby location.
FAYETTEVILLE, NC 28303
FAYETTEVILLE, NC 28303
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1083056782, enumerated as an "organization" on July 23, 2013.
The provider is located at 7559 DECATUR DR FAYETTEVILLE, NC 28303 and the phone number is (910) 484-3717.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
