HEALTHSTAT INC CCBCC CHARLOTTE MINI
NPI 1164033767
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Charlotte, NC

NPI Status: Active since August 17, 2020

Contact Information

801 BLACK SATCHEL RD
CHARLOTTE, NC
ZIP 28216
Phone: (980) 231-3507

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  • Organization
  • Preventive Medicine
  • Preventive Medicine/Occupational Environ...
  • CLIA Number: 34D2021419
  • CLIA Cert. Type: Other - CHRNC DISEASE MGT CLINIC
  • CLIA Exp. Date: 03-13-2027

About HEALTHSTAT INC CCBCC CHARLOTTE MINI

This page provides the complete NPI Profile along with additional information for Healthstat Inc Ccbcc Charlotte Mini, a provider established in Charlotte, North Carolina operating as a Preventive Medicine, focusing in preventive medicine/occupational environmental medicine . The healthcare provider is registered in the NPI registry with number 1164033767 assigned on August 2020. 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 authorized official of this NPI record is Jill Johnson Patton (Director Of Risk Management)

NPI
1164033767
Provider Name
HEALTHSTAT INC CCBCC CHARLOTTE MINI
Entity Type
Organization
Location Address
801 BLACK SATCHEL RD CHARLOTTE, NC 28216
Location Phone
(980) 231-3507
Mailing Address
4651 CHARLOTTE PARK DR STE 300 CHARLOTTE, NC 28217
Mailing Phone
(704) 936-5546
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-17-2020
Last Update Date
08-17-2020
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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

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.

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.

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

JILL JOHNSON PATTON

Authorized Official Title
DIRECTOR OF RISK MANAGEMENT
Authorized Official Phone
(704) 936-5546

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
34D2021419
Facility Type
Other - CHRNC DISEASE MGT CLINIC
Certificate Effective Date
March 14, 2025
Certificate Expiration Date
March 13, 2027
Laboratory Director
DR. SANDRA SIMS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Healthstat Inc Ccbcc Charlotte Mini 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 1164033767, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
3
Unchanged
Pos 7
3
Doubled → 6
Pos 8
7
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
7
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 6 → 12 → 3 0 → 0 3 → 6 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 2 + 4 + 0 + 3 + 6 + 7 + 1 + 2 + 24 = 53

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

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1164033767.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164033767, enumerated as an "organization" on August 17, 2020.

The provider is located at 801 BLACK SATCHEL RD CHARLOTTE, NC 28216 and the phone number is (980) 231-3507.

Preventive Medicine with taxonomy code 2083P0500X and a focus in Preventive Medicine/Occupational Environmental Medicine.