SOUTHFORK MEDICAL CLINIC PLLC
NPI 1205616265
Clinic/Center - Rural Health in Whitley City, KY
NPI Status: Active since October 05, 2023
Contact Information
57 MEDICAL LANE
WHITLEY CITY, KY
ZIP 42653
Phone: (606) 376-7211
Fax: (606) 376-9219
- Organization
- Clinic/Center
- Rural Health
- CLIA Number: 18D1005589
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-21-2026
About SOUTHFORK MEDICAL CLINIC PLLC
This page provides the complete NPI Profile along with additional information for Southfork Medical Clinic Pllc, a primary care provider established in Whitley City, Kentucky operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1205616265 assigned on October 2023. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's
- NPI
- 1205616265
- Provider Legal Name
- SOUTHFORK MEDICAL CLINIC PLLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 57 MEDICAL LANE WHITLEY CITY, KY 42653
- Location Phone
- (606) 376-7211
- Location Fax
- (606) 376-9219
- Mailing Address
- PO BOX 490 WHITLEY CITY, KY 42653
- Mailing Phone
- (606) 376-7211
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-05-2023
- Last Update Date
- 11-25-2025
- Code Navigator
A primary care provider (PCP) like Southfork Medical Clinic Pllc 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
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
- 18D1005589
- Facility Type
- Physician Office
- Certificate Effective Date
- July 22, 2024
- Certificate Expiration Date
- July 21, 2026
- Laboratory Director
- DR. STEVEN THOMPSON
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Southfork Medical Clinic Pllc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha 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 1205616265, 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 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 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 45 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205616265, enumerated as an "organization" on October 05, 2023.
The provider is located at 57 MEDICAL LANE WHITLEY CITY, KY 42653 and the phone number is (606) 376-7211.
Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.
