PLANTATION MANOR
NPI 1114248663
Assisted Living Facility in Thomasville, GA

NPI Status: Active since June 18, 2010

Contact Information

220 PARK AVE
THOMASVILLE, GA
ZIP 31792
Phone: (229) 227-0880
Fax: (229) 227-1217

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 11D2208917
  • CLIA Cert. Type: Other - MED FIRST RESPONDER
  • CLIA Exp. Date: 01-07-2027

About PLANTATION MANOR

This page provides the complete NPI Profile along with additional information for Plantation Manor, a provider established in Thomasville, Georgia operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1114248663 assigned on June 2010. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 16 years ago. The provider's is doing business as Plantation Manor. The authorized official of this NPI record is Gary Blake (Managing Member)

NPI
1114248663
Provider Legal Name
THOMASVILLE I ENTERPRISES, LLC
Other Organization Name
PLANTATION MANOR
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
220 PARK AVE THOMASVILLE, GA 31792
Location Phone
(229) 227-0880
Location Fax
(229) 227-1217
Mailing Address
220 PARK AVE THOMASVILLE, GA 31792
Mailing Phone
(229) 227-0880
Mailing Fax
(229) 227-1217
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-18-2010
Last Update Date
06-18-2010
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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

GARY BLAKE

Authorized Official Title
MANAGING MEMBER
Authorized Official Phone
(817) 348-8841

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
11D2208917
Facility Type
Other - MED FIRST RESPONDER
Certificate Effective Date
January 08, 2025
Certificate Expiration Date
January 07, 2027
Laboratory Director
TIMOTHY C. CONNELL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Plantation Manor 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 1114248663, 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 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
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
2
Doubled → 4
Pos 6
4
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
6
Unchanged
Pos 9
6
Doubled → 12 → 1 + 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 1 → 2 2 → 4 8 → 16 → 7 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 + 2 + 4 + 4 + 4 + 1 + 6 + 6 + 1 + 2 + 24 = 57

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

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1114248663.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Occupational Therapy Assistant
220 PARK AVE
THOMASVILLE, GA 31792
Physical Therapist
220 PARK AVE
THOMASVILLE, GA 31792

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114248663, enumerated as an "organization" on June 18, 2010.

The provider is located at 220 PARK AVE THOMASVILLE, GA 31792 and the phone number is (229) 227-0880.

Assisted Living Facility with taxonomy code 310400000X.