INTEGRATED MEDICAL GROUP, PC
NPI 1184076663
Nurse Practitioner - Family in Fleetwood, PA

NPI Status: Active since July 07, 2016

Contact Information

805 N RICHMOND ST
FLEETWOOD, PA
ZIP 19522
Phone: (610) 944-0464

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  • Organization
  • Nurse Practitioner
  • Family
  • CLIA Number: 39D0205093
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About INTEGRATED MEDICAL GROUP, PC

This page provides the complete NPI Profile along with additional information for Integrated Medical Group, Pc, a provider established in Fleetwood, Pennsylvania operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1184076663 assigned on July 2016. The practitioner's primary taxonomy code is 363LF0000X with license number SP016169 (PA). The provider is registered as an organization and their NPI record was last updated 10 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 Barbara J Mcculley (Office Manager)

NPI
1184076663
Provider Name
INTEGRATED MEDICAL GROUP, PC
Entity Type
Organization
Location Address
805 N RICHMOND ST FLEETWOOD, PA 19522
Location Phone
(610) 944-0464
Mailing Address
4 RAVENS CT READING, PA 19606
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-07-2016
Last Update Date
07-07-2016
Code Navigator

A nurse practitioner (NP) like Integrated Medical Group, Pc 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.

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

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
SP016169
License State
PA

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

BARBARA J MCCULLEY

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(610) 944-0464

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
39D0205093
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
LEIF E. CHRISTIANSEN DO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Integrated Medical Group, Pc 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 1184076663, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

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
8
Doubled → 16 → 1 + 6
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
7
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
6
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
3
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 8 → 16 → 7 0 → 0 6 → 12 → 3 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 + 6 + 4 + 0 + 7 + 1 + 2 + 6 + 1 + 2 + 24 = 57

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

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1184076663.

Other Providers at the Same Location


The following 15 providers are registered at the same or a nearby location.

Family Medicine
805 N RICHMOND ST
FLEETWOOD, PA 19522
Dentist (General Practice)
805 N RICHMOND ST, SUITE 102
FLEETWOOD, PA 19522
Specialist/Technologist (Athletic Trainer)
805 N RICHMOND ST
FLEETWOOD, PA 19522
Family Medicine
805 N RICHMOND ST
FLEETWOOD, PA 19522
Physical Therapist
805 N RICHMOND ST, SUITE 103
FLEETWOOD, PA 19522
Dentist
805 N RICHMOND ST, SUITE 102
FLEETWOOD, PA 19522
Physical Therapist
805 N RICHMOND ST, SUITE 103
FLEETWOOD, PA 19522
Nurse Practitioner (Family)
805 N RICHMOND ST
FLEETWOOD, PA 19522
Nurse Practitioner (Family)
805 N RICHMOND ST
FLEETWOOD, PA 19522
Nurse Practitioner
805 N RICHMOND ST
FLEETWOOD, PA 19522
Nurse Practitioner (Family)
805 N RICHMOND ST
FLEETWOOD, PA 19522
Nurse Practitioner (Adult Health)
805 N RICHMOND ST
FLEETWOOD, PA 19522
Family Medicine
805 N RICHMOND ST
FLEETWOOD, PA 19522
Family Medicine
805 N RICHMOND ST
FLEETWOOD, PA 19522
Family Medicine
805 N RICHMOND ST
FLEETWOOD, PA 19522

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184076663, enumerated as an "organization" on July 07, 2016.

The provider is located at 805 N RICHMOND ST FLEETWOOD, PA 19522 and the phone number is (610) 944-0464.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.