QUINCY MEDICAL GROUP KAHOKA AFFILIATE
NPI 1205402195
Clinic/Center - Rural Health in Kahoka, MO
NPI Status: Active since June 01, 2021
Contact Information
133 E MAIN ST
KAHOKA, MO
ZIP 63445
Phone: (660) 727-3388
Fax: (660) 727-2196
- Organization
- Clinic/Center
- Rural Health
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 26D0715118
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 09-04-2027
About QUINCY MEDICAL GROUP KAHOKA AFFILIATE
This page provides the complete NPI Profile along with additional information for Quincy Medical Group Kahoka Affiliate, a primary care provider established in Kahoka, Missouri operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1205402195 assigned on June 2021. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's other name is Quincy Medical Group Kahoka Affiliate. The authorized official of this NPI record is Patty Woerman (Credentialing Specialist)
- NPI
- 1205402195
- Provider Legal Name
- QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC
- Other Organization Name
- QUINCY MEDICAL GROUP KAHOKA AFFILIATE
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 133 E MAIN ST KAHOKA, MO 63445
- Location Phone
- (660) 727-3388
- Location Fax
- (660) 727-2196
- Mailing Address
- 1025 MAINE ST QUINCY, IL 62301
- Mailing Phone
- (217) 222-6550
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 06-01-2021
- Last Update Date
- 12-20-2021
- Code Navigator
A primary care provider (PCP) like Quincy Medical Group Kahoka Affiliate 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 .
Quincy Medical Group Kahoka Affiliate is a medicare supplier with PTAN 20666993 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: Nebulizer Drugs or Nebulizer Equipment and/or Supplies or Surgical Dressings.
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
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20666993
- Accepts Medicare Assignment
- YES
- Provider Type List
- NURSE PRACTITIONER, PHYSICIAN – FAMILY PRACTICE.
- Competitive Bidding
- NO
Supplies List
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
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
- 26D0715118
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- September 05, 2025
- Certificate Expiration Date
- September 04, 2027
- Laboratory Director
- NEVILLE Q. CRENSHAW
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Quincy Medical Group Kahoka Affiliate 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 1205402195, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
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 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
KAHOKA, MO 63445
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205402195, enumerated as an "organization" on June 01, 2021.
The provider is located at 133 E MAIN ST KAHOKA, MO 63445 and the phone number is (660) 727-3388.
Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.
