GIBSON RECOVERY OPTIMIZING WELLNESS
NPI 1093448011
Family Medicine - Addiction Medicine in Gibson City, IL

NPI Status: Active since July 07, 2022

Contact Information

10 DOCTORS PARK
GIBSON CITY, IL
ZIP 60936
Phone: (217) 784-4251

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Family Medicine
Addiction Medicine
CLIA Number: 14D1027353
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 10-31-2026

About GIBSON RECOVERY OPTIMIZING WELLNESS

This page provides the complete NPI Profile along with additional information for Gibson Recovery Optimizing Wellness, a provider established in Gibson City, Illinois operating as a Family Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1093448011 assigned on July 2022. The practitioner's primary taxonomy code is 207QA0401X. The provider is registered as an organization and their NPI record was last updated 4 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 is doing business as Gibson Recovery Optimizing Wellness. The authorized official of this NPI record is Matthew Ertel (Chief Financial Officer)

NPI: 1093448011
Provider Legal Name: GIBSON COMMUNITY HOSPITAL ASSOCIATION
Other Organization Name: GIBSON RECOVERY OPTIMIZING WELLNESS
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 10 DOCTORS PARK GIBSON CITY, IL 60936
Location Phone: (217) 784-4251
Mailing Address: 1120 N MELVIN ST GIBSON CITY, IL 60936
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 07-07-2022
Last Update Date: 08-02-2022
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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: Family Medicine Addiction Medicine
Taxonomy Code: 207QA0401X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: A family medicine physician who specializes in the diagnosis and treatment of addictions.

Group Taxonomy 193400000X MULTIPLE 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: MATTHEW ERTEL
Authorized Official Title: CHIEF FINANCIAL OFFICER
Authorized Official Phone: (217) 784-2601

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: 14D1027353
Facility Type: Physician Office
Certificate Effective Date: November 01, 2024
Certificate Expiration Date: October 31, 2026
Laboratory Director: KATHERINE AUSTMAN MD
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Gibson Recovery Optimizing Wellness in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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 1093448011, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 8

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

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 9 → 18 → 9 4 → 8 8 → 16 → 7 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 + 8 + 3 + 8 + 4 + 1 + 6 + 0 + 2 + 24 = 59

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

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1

This NPI is valid

The calculated check digit is 1, which matches the last digit of 1093448011.