ST GEORGE CLINICS, LLC
NPI 1194216416
Clinic/Center - Multi-Specialty in Waterford, WI
NPI Status: Active since May 22, 2018
Contact Information
308 E MAIN ST
WATERFORD, WI
ZIP 53185
Phone: (262) 923-3777
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 52D2151254
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-18-2026
About ST GEORGE CLINICS, LLC
This page provides the complete NPI Profile along with additional information for St George Clinics, Llc, a provider established in Waterford, Wisconsin operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1194216416 assigned on May 2018. The practitioner's primary taxonomy code is 261QM1300X with license number 52D1037628 (WI). The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Mrs. Tatjana Stevanovic Np (Adult Nurse Practioner)
- NPI
- 1194216416
- Provider Name
- ST GEORGE CLINICS, LLC
- Entity Type
- Organization
- Location Address
- 308 E MAIN ST WATERFORD, WI 53185
- Location Phone
- (262) 923-3777
- Mailing Address
- 308 E MAIN ST WATERFORD, WI 53185
- Mailing Phone
- (262) 923-3777
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-22-2018
- Last Update Date
- 11-20-2023
- Code Navigator
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 Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
- License No.
- 52D1037628
- License State
- WI
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 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 52D2151254
- Facility Type
- Physician Office
- Certificate Effective Date
- February 19, 2024
- Certificate Expiration Date
- February 18, 2026
- Laboratory Director
- DR. NEBOJSA STEVANOVIC
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to St George Clinics, Llc 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 1194216416, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
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 54 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194216416, enumerated as an "organization" on May 22, 2018.
The provider is located at 308 E MAIN ST WATERFORD, WI 53185 and the phone number is (262) 923-3777.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
