KIDMED STAFFORD
NPI 1174042022
Clinic/Center - Urgent Care in Stafford, VA

NPI Status: Active since September 12, 2017

Contact Information

20 DOC STONE RD
STAFFORD, VA
ZIP 22556
Phone: (804) 647-2240

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  • Organization
  • Clinic/Center
  • Urgent Care
  • CLIA Number: 49D2093143
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-03-2027

About KIDMED STAFFORD

This page provides the complete NPI Profile along with additional information for Kidmed Stafford, a provider established in Stafford, Virginia operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1174042022 assigned on September 2017. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Kidmed Stafford. The authorized official of this NPI record is Dr. Mark A Flanzenbaum Md (President)

NPI
1174042022
Provider Legal Name
KIDMED INC.
Other Organization Name
KIDMED STAFFORD
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
20 DOC STONE RD STAFFORD, VA 22556
Location Phone
(804) 647-2240
Mailing Address
20 DOC STONE RD STAFFORD, VA 22556
Mailing Phone
(804) 647-2240
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
09-12-2017
Last Update Date
08-30-2023
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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

Clinic/Center Urgent Care

Taxonomy Code
261QU0200X
Type
Ambulatory Health Care Facilities

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

DR. MARK A FLANZENBAUM MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(804) 592-5437

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
49D2093143
Facility Type
Physician Office
Certificate Effective Date
August 04, 2025
Certificate Expiration Date
August 03, 2027
Laboratory Director
JEFFREY E. BENNETT
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Kidmed Stafford after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high 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 1174042022, we treat the final digit (2) 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 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).

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

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 4 + 4 + 0 + 4 + 4 + 0 + 4 + 24 = 48

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

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1174042022.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Nurse Practitioner (Pediatrics)
20 DOC STONE RD
STAFFORD, VA 22556
Nurse Practitioner (Family)
20 DOC STONE RD
STAFFORD, VA 22556
Nurse Practitioner (Pediatrics)
20 DOC STONE RD
STAFFORD, VA 22556
Nurse Practitioner (Pediatrics)
20 DOC STONE RD
STAFFORD, VA 22556
Physician Assistant (Medical)
20 DOC STONE RD
STAFFORD, VA 22556

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174042022, enumerated as an "organization" on September 12, 2017.

The provider is located at 20 DOC STONE RD STAFFORD, VA 22556 and the phone number is (804) 647-2240.

Clinic/Center with taxonomy code 261QU0200X and a focus in Urgent Care.