WALMART CARE CLINIC 10-0511
NPI 1114332665
Nurse Practitioner in Sumter, SC
NPI Status: Active since June 24, 2014
Contact Information
1283 BROAD ST
SUMTER, SC
ZIP 29150
Phone: (803) 905-5528
Fax: (803) 905-5530
- Organization
- Nurse Practitioner
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
- CLIA Number: 42D2080768
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 07-13-2026
About WALMART CARE CLINIC 10-0511
This page provides the complete NPI Profile along with additional information for Walmart Care Clinic 10-0511, a provider established in Sumter, South Carolina operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1114332665 assigned on June 2014. The practitioner's primary taxonomy code is 363L00000X. The provider is registered as an organization and their NPI record was last updated 11 years ago. Walmart Care Clinic 10-0511 operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's other name is Walmart Care Clinic 10-0511. The authorized official of this NPI record is Laura Levine (Director Of Healthcare Contracting)
- NPI
- 1114332665
- Provider Legal Name
- WAL-MART STORES EAST, LP
- Other Organization Name
- WALMART CARE CLINIC 10-0511
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 1283 BROAD ST SUMTER, SC 29150
- Location Phone
- (803) 905-5528
- Location Fax
- (803) 905-5530
- Mailing Address
- 702 SW 8TH ST BENTONVILLE, AR 72716
- Mailing Phone
- (479) 204-8550
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 06-24-2014
- Last Update Date
- 02-19-2015
- Code Navigator
A nurse practitioner (NP) like Walmart Care Clinic 10-0511 is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Walmart Care Clinic 10-0511 is a medicare supplier with PTAN 20495219 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order) or Blood Glucose Monitors/Supplies (Mail Order) or Ostomy Supplies or Prosthetic Lenses: Conventional Eyeglasses or Enteral Nutrients or Surgical Dressings.
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
Nurse Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| D953 | OTHER (01) | SC | MEDICARE PTAN |
| GP6498 | MEDICAID (05) | SC |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20495219
- Accepts Medicare Assignment
- NO
- Specialities List
- Pharmacy, Optician.
- Competitive Bidding
- NO
Supplies List
- Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
- Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
- Blood Glucose Monitors/Supplies (Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Enteral Nutrients - Enteral formula
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
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
- 42D2080768
- Facility Type
- Community Clinic
- Certificate Effective Date
- July 14, 2024
- Certificate Expiration Date
- July 13, 2026
- Laboratory Director
- LYNN SCARBROUGH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Walmart Care Clinic 10-0511 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 1114332665, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
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 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114332665, enumerated as an "organization" on June 24, 2014.
The provider is located at 1283 BROAD ST SUMTER, SC 29150 and the phone number is (803) 905-5528.
Nurse Practitioner with taxonomy code 363L00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
