STATESVILLE ASSISTED LIVING
NPI 1124191804
Preferred Provider Organization in Statesville, NC

NPI Status: Active since November 17, 2006

Contact Information

2147 DAVIE AVE
STATESVILLE, NC
ZIP 28625
Phone: (704) 878-0123
Fax: (704) 878-8689

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  • Preferred Provider Organization

About STATESVILLE ASSISTED LIVING

This page provides the complete NPI Profile along with additional information for Statesville Assisted Living, a provider established in Statesville, North Carolina operating as a Preferred Provider Organization. The healthcare provider is registered in the NPI registry with number 1124191804 assigned on November 2006. The practitioner's primary taxonomy code is 305R00000X with license number HAL-049-023 (NC). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Mr. Aldo Baccala (Execuitve Officer)

NPI
1124191804
Provider Name
STATESVILLE ASSISTED LIVING
Entity Type
Organization
Location Address
2147 DAVIE AVE STATESVILLE, NC 28625
Location Phone
(704) 878-0123
Location Fax
(704) 878-8689
Mailing Address
2147 DAVIE AVE STATESVILLE, NC 28625
Mailing Phone
(704) 878-0123
Mailing Fax
(704) 878-8689
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-17-2006
Last Update Date
08-22-2020
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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

Preferred Provider Organization

Taxonomy Code
305R00000X
Type
Managed Care Organizations
License No.
HAL-049-023
License State
NC
Taxonomy Description
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

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.

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

MR. ALDO BACCALA

Authorized Official Title
EXECUITVE OFFICER
Authorized Official Phone
(707) 778-6719

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
7804765MEDICAID (05)NC 

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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 1124191804, 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 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
2
Doubled → 4
Pos 4
4
Unchanged
Pos 5
1
Doubled → 2
Pos 6
9
Unchanged
Pos 7
1
Doubled → 2
Pos 8
8
Unchanged
Pos 9
0
Doubled → 0
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 2 → 4 1 → 2 1 → 2 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 4 + 4 + 2 + 9 + 2 + 8 + 0 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1124191804.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Assisted Living Facility
2147 DAVIE AVE
STATESVILLE, NC 28625
Occupational Therapist
2147 DAVIE AVE, GARDENS OF STATESVILLE
STATESVILLE, NC 28625
Physical Therapist
2147 DAVIE AVE
STATESVILLE, NC 28625

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124191804, enumerated as an "organization" on November 17, 2006.

The provider is located at 2147 DAVIE AVE STATESVILLE, NC 28625 and the phone number is (704) 878-0123.

Preferred Provider Organization with taxonomy code 305R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.