HEALTHSTAT ON-SITE CLINIC/POLK COUNTY
NPI 1134495245
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Haines City, FL
NPI Status: Active since March 23, 2012
Contact Information
631B US HIGHWAY 17 92 W
HAINES CITY, FL
ZIP 33844
Phone: (863) 519-3858
- Organization
- Preventive Medicine
- Preventive Medicine/Occupational Environ...
- Accepts Insurance
- CLIA Number: 42D1074056
- CLIA Cert. Type: Other
- CLIA Exp. Date: 09-20-2027
About HEALTHSTAT ON-SITE CLINIC/POLK COUNTY
This page provides the complete NPI Profile along with additional information for Healthstat On-site Clinic/polk County, a provider established in Haines City, Florida operating as a Preventive Medicine, focusing in preventive medicine/occupational environmental medicine . The healthcare provider is registered in the NPI registry with number 1134495245 assigned on March 2012. The practitioner's primary taxonomy code is 2083P0500X. 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 Healthstat On-site Clinic/polk County. The authorized official of this NPI record is Jill Johnson Patton (Director Of Risk Management)
- NPI
- 1134495245
- Provider Legal Name
- HEALTHSTAT WELLNESS-POLK HAINES
- Other Organization Name
- HEALTHSTAT ON-SITE CLINIC/POLK COUNTY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 631B US HIGHWAY 17 92 W HAINES CITY, FL 33844
- Location Phone
- (863) 519-3858
- Mailing Address
- 4601 CHARLOTTE PARK DR SUITE 390 CHARLOTTE, NC 28217
- Mailing Phone
- (704) 529-6161
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-23-2012
- Last Update Date
- 07-14-2020
- 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
Preventive Medicine Preventive Medicine/Occupational Environmental Medicine
- Taxonomy Code
- 2083P0500X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 3336C0002X | Suppliers | Pharmacy |
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:
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-05 (Rewards) - POS
- BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-18 (Rewards) - POS
- BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS
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 |
|---|---|---|---|
| 5709730 | OTHER (01) | NCPDP PROVIDER IDENTIFICATION 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
- 42D1074056
- Facility Type
- Other
- Certificate Effective Date
- September 21, 2025
- Certificate Expiration Date
- September 20, 2027
- Laboratory Director
- SALLY POOLE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Healthstat On-site Clinic/polk County 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.
Reviews for HEALTHSTAT ON-SITE CLINIC/POLK COUNTY
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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 1134495245, 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 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 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
HAINES CITY, FL 33844
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1134495245, enumerated as an "organization" on March 23, 2012.
The provider is located at 631B US HIGHWAY 17 92 W HAINES CITY, FL 33844 and the phone number is (863) 519-3858.
Preventive Medicine with taxonomy code 2083P0500X and a focus in Preventive Medicine/Occupational Environmental Medicine.
The provider might be accepting Accepts: Florida Blue HMO (a BlueCross BlueShield FL. Please consult your insurance carrier or call the provider to verify.
