PEDIATRIC & ADOLESCENT CLINIC
NPI 1174608020
Clinic/Center - Rural Health in Natchez, MS
NPI Status: Active since October 26, 2006
Contact Information
308 HIGHLAND BLVD
NATCHEZ, MS
ZIP 39120
Phone: (601) 442-7676
Fax: (601) 442-9590
- Organization
- Clinic/Center
- Rural Health
- CLIA Number: 25D0855965
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-27-2026
About PEDIATRIC & ADOLESCENT CLINIC
This page provides the complete NPI Profile along with additional information for Pediatric & Adolescent Clinic, a primary care provider established in Natchez, Mississippi operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1174608020 assigned on October 2006. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 19 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 Pediatric & Adolescent Clinic. The authorized official of this NPI record is Dr. David Alan Timm M. D. (Owner)
- NPI
- 1174608020
- Provider Legal Name
- DAVID ALAN TIMM
- Other Organization Name
- PEDIATRIC & ADOLESCENT CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 308 HIGHLAND BLVD NATCHEZ, MS 39120
- Location Phone
- (601) 442-7676
- Location Fax
- (601) 442-9590
- Mailing Address
- 308 HIGHLAND BLVD NATCHEZ, MS 39120
- Mailing Phone
- (601) 442-7676
- Mailing Fax
- (601) 442-9590
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-26-2006
- Last Update Date
- 01-02-2008
- Code Navigator
A primary care provider (PCP) like Pediatric & Adolescent Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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
Clinic/Center Rural Health
- Taxonomy Code
- 261QR1300X
- Type
- Ambulatory Health Care Facilities
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 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | C5115 (MS) |
| 2 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 10207 (MS) |
| 3 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 016299 (LA) |
| 4 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | R691941 (MS) |
| 5 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | RN066376 APO4870 (LA) |
| 6 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | R863841 (MS) |
| 7 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | RN109495 APO04933 (LA) |
Group Taxonomy 193400000X MULTIPLE 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.
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 |
|---|---|---|---|
| 258948 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| 1446009 | MEDICAID (05) | LA | |
| 09015251 | MEDICAID (05) | MS |
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
- 25D0855965
- Facility Type
- Physician Office
- Certificate Effective Date
- July 28, 2024
- Certificate Expiration Date
- July 27, 2026
- Laboratory Director
- DAVID A. TIMM
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Pediatric & Adolescent Clinic 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 1174608020, 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 7 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174608020, enumerated as an "organization" on October 26, 2006.
The provider is located at 308 HIGHLAND BLVD NATCHEZ, MS 39120 and the phone number is (601) 442-7676.
Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
