SOUTH SALEM IMMEDIATE CARE
NPI 1124311550
Specialist in Salem, OR
NPI Status: Active since May 18, 2011
Contact Information
3777 COMMERCIAL ST SE
SALEM, OR
ZIP 97302
Phone: (503) 588-1234
Fax: (503) 371-8662
- Organization
- Specialist
- CLIA Number: 38D0625680
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-31-2027
About SOUTH SALEM IMMEDIATE CARE
This page provides the complete NPI Profile along with additional information for South Salem Immediate Care, a provider established in Salem, Oregon operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1124311550 assigned on May 2011. The practitioner's primary taxonomy code is 174400000X with license number MD10412 (OR). The provider is registered as an organization and their NPI record was last updated 15 years ago. South Salem Immediate Care operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as South Salem Immediate Care. The authorized official of this NPI record is Karleen Rae Kitzmiller (Owner)
- NPI
- 1124311550
- Provider Legal Name
- URGENT CARE CLINIC SOUTH
- Other Organization Name
- SOUTH SALEM IMMEDIATE CARE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3777 COMMERCIAL ST SE SALEM, OR 97302
- Location Phone
- (503) 588-1234
- Location Fax
- (503) 371-8662
- Mailing Address
- 3777 COMMERCIAL ST SE SALEM, OR 97302
- Mailing Phone
- (503) 588-1234
- Mailing Fax
- (503) 371-8662
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-18-2011
- Last Update Date
- 05-18-2011
- Code Navigator
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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- MD10412
- License State
- OR
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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.
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
- 38D0625680
- Facility Type
- Physician Office
- Certificate Effective Date
- January 01, 2026
- Certificate Expiration Date
- December 31, 2027
- Laboratory Director
- SCOTT F. MILLER MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to South Salem Immediate Care in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 1124311550, we treat the final digit (0) 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 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
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 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124311550, enumerated as an "organization" on May 18, 2011.
The provider is located at 3777 COMMERCIAL ST SE SALEM, OR 97302 and the phone number is (503) 588-1234.
Specialist with taxonomy code 174400000X.
