MAGIC VALLEY MEDICINE PLLC NPI 1174939383
Nurse Practitioner (Family) in Twin Falls, ID
NPI Profile for MAGIC VALLEY MEDICINE PLLC
Magic Valley Medicine Pllc is a provider established in Twin Falls, Idaho specializing in nurse practitioner (family) . The NPI number of Magic Valley Medicine Pllc is 1174939383 and was assigned on July 2014. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Samuel H Barker (Sole Member)
A nurse practitioner (NP) like Magic Valley Medicine Pllc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Magic Valley Medicine Pllc is a medicare supplier with PTAN 7369300001 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Traction Equipment or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Orthoses: Off-The-Shelf.
The CLIA number of Magic Valley Medicine Pllc is 13D2204932 registered as a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Magic Valley Medicine Pllc 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.
| NPI | 1174939383 |
| Provider Name | MAGIC VALLEY MEDICINE PLLC |
| Provider Location Address | 844 WASHINGTON ST N STE 400 TWIN FALLS, ID 83301 |
| Provider Mailing Address | 844 WASHINGTON ST N STE 400 TWIN FALLS, ID 83301 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 07-08-2014 |
| Last Update Date | 07-11-2016 |
Primary Taxonomy
| Taxonomy Code | 363LF0000X |
| Classification | Nurse Practitioner |
| Type | Physician Assistants & Advanced Practice Nursing Providers |
| Specialization | Family |
Business Address
MAGIC VALLEY MEDICINE PLLC
844 WASHINGTON ST N STE 400
TWIN FALLS, ID
ZIP 83301
Phone: (208) 734-0000
Fax: (208) 735-5053
Mailing Address
MAGIC VALLEY MEDICINE PLLC
844 WASHINGTON ST N STE 400
TWIN FALLS, ID
ZIP 83301
Phone: (208) 734-0000
Fax: (208) 735-5053
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
| PTAN | 7369300001 |
| Accepts Medicare Assignment | YES |
| Provider Type List | NURSE PRACTITIONER. |
| Supplies List |
|
| Competitive Bidding | NO |
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 the NPI number 1174939383 is:
| CLIA Number | 13D2204932 |
| Facility Type | PHYSICIAN OFFICE |
| Certificate Type | Certificate for Provider-Performed Microscopy Procedures (PPMP) |
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | No | |||
Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1174939383 | MEDICAID (05) | ID | |
| 7369300001 | OTHER (01) | MEDICARE DME | |
| 20005523 | MEDICARE PIN (08) |
NPI Validation Check Digit Calculation
The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 9 | 3 | 9 | 3 | 8 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 18 | 3 | 18 | 3 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 8 + 3 + 1 + 8 + 3 + 1 + 6 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1174939383 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the same location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1669787636 | JILLIAN MARJORIE SIRUCEK ADEPOJU D.C. Individual | Chiropractor | 844 WASHINGTON ST N STE 400 TWIN FALLS, ID 83301 (208) 736-8858 |
| 1831644608 | MAGIC VALLEY MEDICINE PLLC Organization | Durable Medical Equipment & Medical Supplies | 844 WASHINGTON ST N STE 400 TWIN FALLS, ID 83301 (208) 734-0000 |
| 1043301682 | DR. SAMUEL HARRISON BARKER D.C., NP-C Individual | Nurse Practitioner (Family) | 844 WASHINGTON ST N STE 400 TWIN FALLS, ID 83301 (208) 734-0000 |
| 1821603382 | QUICKER CARE PLLC Organization | Clinic/Center (Urgent Care) | 844 WASHINGTON ST N STE 400 TWIN FALLS, ID 83301 (208) 734-0000 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Magic Valley Medicine Pllc is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.