HEALTHSTAT ONSITE CLINIC KEIHIN MUNCIE
NPI 1104280064
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Muncie, IN

NPI Status: Active since April 07, 2016

Contact Information

4400 N SUPERIOR DR
MUNCIE, IN
ZIP 47303
Phone: (657) 282-0951

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  • Organization
  • Preventive Medicine
  • Preventive Medicine/Occupational Environ...
  • CLIA Number: 15D2113113
  • CLIA Cert. Type: Other - CHRONIC MGT CLINIC
  • CLIA Exp. Date: 05-16-2028

About HEALTHSTAT ONSITE CLINIC KEIHIN MUNCIE

This page provides the complete NPI Profile along with additional information for Healthstat Onsite Clinic Keihin Muncie, a provider established in Muncie, Indiana operating as a Preventive Medicine, focusing in preventive medicine/occupational environmental medicine . The healthcare provider is registered in the NPI registry with number 1104280064 assigned on April 2016. The practitioner's primary taxonomy code is 2083P0500X. 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 authorized official of this NPI record is Jill Patton (Director Of Risk Management)

NPI
1104280064
Provider Name
HEALTHSTAT ONSITE CLINIC KEIHIN MUNCIE
Entity Type
Organization
Location Address
4400 N SUPERIOR DR MUNCIE, IN 47303
Location Phone
(657) 282-0951
Mailing Address
4651 CHARLOTTE PARK DR SUITE 300 CHARLOTTE, NC 28217
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-07-2016
Last Update Date
11-28-2022
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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

Preventive Medicine Preventive Medicine/Occupational Environmental Medicine

Taxonomy Code
2083P0500X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

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

JILL PATTON

Authorized Official Title
DIRECTOR OF RISK MANAGEMENT
Authorized Official Phone
(704) 529-6161

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
15D2113113
Facility Type
Other - CHRONIC MGT CLINIC
Certificate Effective Date
May 17, 2026
Certificate Expiration Date
May 16, 2028
Laboratory Director
JENTRY O DANIEL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Healthstat Onsite Clinic Keihin Muncie 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 1104280064, we treat the final digit (4) 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 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

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
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
2
Doubled → 4
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
0
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
4
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 0 → 0 2 → 4 0 → 0 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 0 + 4 + 4 + 8 + 0 + 0 + 1 + 2 + 24 = 46

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

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1104280064.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104280064, enumerated as an "organization" on April 07, 2016.

The provider is located at 4400 N SUPERIOR DR MUNCIE, IN 47303 and the phone number is (657) 282-0951.

Preventive Medicine with taxonomy code 2083P0500X and a focus in Preventive Medicine/Occupational Environmental Medicine.