MAGNOLIA HEALTHCARE CENTER LLC GROUP
NPI 1215209648
Nurse Practitioner in Magnolia, AR

NPI Status: Active since February 01, 2012

Contact Information

2642 N DUDNEY RD
MAGNOLIA, AR
ZIP 71753
Phone: (870) 234-7000
Fax: (870) 234-7168

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Nurse Practitioner
CLIA Number: 04D0691015
CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
CLIA Exp. Date: 08-27-2025

About MAGNOLIA HEALTHCARE CENTER LLC GROUP

This page provides the complete NPI Profile along with additional information for Magnolia Healthcare Center Llc Group, a provider established in Magnolia, Arkansas operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1215209648 assigned on February 2012. The practitioner's primary taxonomy code is 363L00000X with license number A01537 (AR). The provider is registered as an organization and their NPI record was last updated 14 years ago. Magnolia Healthcare Center Llc Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Ms. Jeanne H Butterworth (Member)

NPI: 1215209648
Provider Name: MAGNOLIA HEALTHCARE CENTER LLC GROUP
Entity Type: Organization
Location Address: 2642 N DUDNEY RD MAGNOLIA, AR 71753
Location Phone: (870) 234-7000
Location Fax: (870) 234-7168
Mailing Address: 2642 N DUDNEY RD MAGNOLIA, AR 71753
Mailing Phone: (870) 234-7000
Mailing Fax: (870) 234-7168
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 02-01-2012
Last Update Date: 02-01-2012
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A nurse practitioner (NP) like Magnolia Healthcare Center Llc Group 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
Taxonomy Code: 363L00000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: A01537
License State: AR
Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas 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: MS. JEANNE H BUTTERWORTH
Authorized Official Title: MEMBER
Authorized Official Phone: (410) 527-4083

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: 04D0691015
Facility Type: Skilled Nursing Facility/Nursing Facility
Certificate Effective Date: August 28, 2023
Certificate Expiration Date: August 27, 2025
Laboratory Director: MS. SUSAN HOPPER
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Magnolia Healthcare Center Llc Group 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.

NPI Validation Check Digit Calculation

The following table explains the step by step 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	2	1	5	2	0	9	6	4	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	2	5	4	0	18	6	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 2 + 5 + 4 + 0 + 1 + 8 + 6 + 8 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 8									8

The NPI number 1215209648 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.