A DEPARTMENT OF ELLSWORTH HOSPITAL
NPI 1124307129
Nurse Practitioner - Family in Ackley, IA

NPI Status: Active since August 08, 2011

Contact Information

1000 10TH AVE
ACKLEY, IA
ZIP 50601
Phone: (641) 847-2625
Fax: (641) 847-2509

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  • Organization
  • Nurse Practitioner
  • Family
  • CLIA Number: 16D0384461
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-31-2026

About A DEPARTMENT OF ELLSWORTH HOSPITAL

This page provides the complete NPI Profile along with additional information for A Department Of Ellsworth Hospital, a provider established in Ackley, Iowa operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1124307129 assigned on August 2011. The practitioner's primary taxonomy code is 363LF0000X with license number 118827 (IA). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as A Department Of Ellsworth Hospital. The authorized official of this NPI record is Darla Sue Nederhoff (Clinic Manager)

NPI
1124307129
Provider Legal Name
ACKLEY MEDICAL CENTER
Other Organization Name
A DEPARTMENT OF ELLSWORTH HOSPITAL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1000 10TH AVE ACKLEY, IA 50601
Location Phone
(641) 847-2625
Location Fax
(641) 847-2509
Mailing Address
1000 10TH AVE ACKLEY, IA 50601
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
08-08-2011
Last Update Date
12-03-2020
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A nurse practitioner (NP) like A Department Of Ellsworth Hospital 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.

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 Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
118827
License State
IA

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.

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

DARLA SUE NEDERHOFF

Authorized Official Title
CLINIC MANAGER
Authorized Official Phone
(641) 847-2625

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
118827OTHER (01)IALICENSE NUMBER

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
16D0384461
Facility Type
Physician Office
Certificate Effective Date
August 01, 2024
Certificate Expiration Date
July 31, 2026
Laboratory Director
ADAM WATERMAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to A Department Of Ellsworth Hospital 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 1124307129, we treat the final digit (9) 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 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

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
3
Doubled → 6
Pos 6
0
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
1
Unchanged
Pos 9
2
Doubled → 4
Check
9
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 3 → 6 7 → 14 → 5 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 4 + 4 + 6 + 0 + 1 + 4 + 1 + 4 + 24 = 51

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

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1124307129.

Other Providers at the Same Location


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

Nurse Practitioner (Family)
1000 10TH AVE
ACKLEY, IA 50601
Nurse Practitioner (Family)
1000 10TH AVE
ACKLEY, IA 50601
Family Medicine
1000 10TH AVE
ACKLEY, IA 50601

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124307129, enumerated as an "organization" on August 08, 2011.

The provider is located at 1000 10TH AVE ACKLEY, IA 50601 and the phone number is (641) 847-2625.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

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