INTERNAL MEDICINE DIAGNOSTICS INC NPI 1114913936

Internal Medicine in Cherokee Village, AR

NPI 1114913936 Organization Internal Medicine CLIA Number 04D0941101 CLIA Certificate of Waiver

About INTERNAL MEDICINE DIAGNOSTICS INC

Internal Medicine Diagnostics Inc is an internal medicine provider established in Cherokee Village, Arkansas specializing in internal medicine. The NPI number of Internal Medicine Diagnostics Inc is 1114913936 and was assigned on September 2005. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. Internal Medicine Diagnostics Inc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Ms. Nirmal K Sidhu Dvm, Msc (Office Manager)

An internist like Internal Medicine Diagnostics Inc 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.

The CLIA number of Internal Medicine Diagnostics Inc is 04D0941101 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Internal Medicine Diagnostics Inc 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.

NPI

1114913936

Provider NameINTERNAL MEDICINE DIAGNOSTICS INC
Provider Location Address197 HOSPITAL DR SUITE B CHEROKEE VILLAGE, AR 72529
Provider Mailing Address197 HOSPITAL DR SUITE B CHEROKEE VILLAGE, AR 72529
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-27-2005
Last Update Date08-07-2007


Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionA 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.

Business Address

INTERNAL MEDICINE DIAGNOSTICS INC
197 HOSPITAL DR
SUITE B
CHEROKEE VILLAGE, AR
ZIP 72529
Phone: (870) 257-5118

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Mailing Address

INTERNAL MEDICINE DIAGNOSTICS INC
197 HOSPITAL DR
SUITE B
CHEROKEE VILLAGE, AR
ZIP 72529
Phone: (870) 257-5118



Authorized Official

Authorized Official NameMS. NIRMAL K SIDHU DVM, MSC
Authorized Official TitleOFFICE MANAGER
Authorized Official Phone(870) 257-5118

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 the NPI number 1114913936 is:

CLIA Number04D0941101
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

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.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
X46053MEDICARE UPIN (02)AR
5C283MEDICARE ID-TYPE UNSPECIFIED (04)AR

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1508846015WHITE RIVER HEALTH SYSTEM, INC.
Organization
Clinic/Center (Primary Care)197 HOSPITAL DR
CHEROKEE VILLAGE, AR 72529
(870) 257-6070
1700845740 SURINDER P S SRA M.D.
Individual
Internal Medicine197 HOSPITAL DR SUITE B
CHEROKEE VLG, AR 72529
(870) 257-5118
1528022209MRS. JANET SUE TORBIT APN
Individual
Nurse Practitioner (Adult Health)197 HOSPITAL DR SUITE B
CHEROKEE VILLAGE, AR 72529
(870) 257-5118
1215118492WHITE RIVER HEALTH SYSTEM,INC.
Organization
Clinic/Center (Ambulatory Surgical)197 HOSPITAL DR SUITE D
CHEROKEE VILLAGE, AR 72529
(870) 257-6070
1821423849WHITE RIVER HEALTH SYSTEM, INC.
Organization
Emergency Medicine197 HOSPITAL DR SUITE C
CHEROKEE VILLAGE, AR 72529
(870) 257-6070

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.