CONVIVA PALM BEACH GARDENS
NPI 1104490507
Internal Medicine in Palm Beach Gardens, FL
NPI Status: Active since May 19, 2021
Contact Information
9121 N MILITARY TRL STE 111
PALM BEACH GARDENS, FL
ZIP 33410
Phone: (561) 626-7604
Fax: (561) 626-1506
- Organization
- Internal Medicine
- CLIA Number: 10D0700096
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-31-2026
About CONVIVA PALM BEACH GARDENS
This page provides the complete NPI Profile along with additional information for Conviva Palm Beach Gardens, an internist established in Palm Beach Gardens, Florida operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1104490507 assigned on May 2021. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Conviva Palm Beach Gardens operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's other name is Conviva Palm Beach Gardens. The authorized official of this NPI record is Kevin Meriwether (President)
- NPI
- 1104490507
- Provider Legal Name
- CONVIVA MEDICAL CENTER MANAGEMENT LLC
- Other Organization Name
- CONVIVA PALM BEACH GARDENS
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 9121 N MILITARY TRL STE 111 PALM BEACH GARDENS, FL 33410
- Location Phone
- (561) 626-7604
- Location Fax
- (561) 626-1506
- Mailing Address
- 6101 BLUE LAGOON DR STE 200 MIAMI, FL 33126
- Mailing Phone
- (305) 500-2000
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-19-2021
- Last Update Date
- 05-20-2024
- Code Navigator
An internist like Conviva Palm Beach Gardens is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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
- 10D0700096
- Facility Type
- Physician Office
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- WILLIAM M. RUSSELL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Conviva Palm Beach Gardens 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. | |||||||||
| 1 | 1 | 0 | 4 | 4 | 9 | 0 | 5 | 0 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 8 | 9 | 0 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 0 + 4 + 8 + 9 + 0 + 5 + 0 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1104490507 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
RATNA CHODAY MD
Internal Medicine
9121 N MILITARY TRL STE 111
PALM BEACH GARDENS, FL
ZIP 33410
KATHLEEN J LAFFERTY ARNP
Nurse Practitioner
(Family)
9121 N MILITARY TRL STE 111
PALM BEACH GARDENS, FL
ZIP 33410
SAEED FARAHMANDFAR MD
Internal Medicine
9121 N MILITARY TRL STE 111
PALM BEACH GARDENS, FL
ZIP 33410
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104490507, enumerated as an "organization" on May 19, 2021.
The provider is located at 9121 N MILITARY TRL STE 111 PALM BEACH GARDENS, FL 33410 and the phone number is (561) 626-7604.
Internal Medicine with taxonomy code 207R00000X.
