PALADIN DERMATOLOGY LLC
NPI 1225417082
Nurse Practitioner in Petersburg, VA

NPI Status: Active since May 27, 2015

Contact Information

44 A& B MEDICAL PARK BLVD
PETERSBURG, VA
ZIP 23805
Phone: (804) 648-4802

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  • Organization
  • Nurse Practitioner
  • CLIA Number: 49D2139632
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 11-05-2025

About PALADIN DERMATOLOGY LLC

This page provides the complete NPI Profile along with additional information for Paladin Dermatology Llc, a provider established in Petersburg, Virginia operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1225417082 assigned on May 2015. The practitioner's primary taxonomy code is 363L00000X with license number 0024164803 (VA). The provider is registered as an organization and their NPI record was last updated 11 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 Joe Hernandez (Managing Official)

NPI
1225417082
Provider Name
PALADIN DERMATOLOGY LLC
Entity Type
Organization
Location Address
44 A& B MEDICAL PARK BLVD PETERSBURG, VA 23805
Location Phone
(804) 648-4802
Mailing Address
1801 LIBBIE AVE STE 204 RICHMOND, VA 23226
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-27-2015
Last Update Date
10-27-2015
Code Navigator

A nurse practitioner (NP) like Paladin Dermatology Llc 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.

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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.
0024164803
License State
VA
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 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

JOE HERNANDEZ

Authorized Official Title
MANAGING OFFICIAL
Authorized Official Phone
(804) 648-4802

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
49D2139632
Facility Type
Physician Office
Certificate Effective Date
November 06, 2023
Certificate Expiration Date
November 05, 2025
Laboratory Director
SHARON S. CAMDEN
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Paladin Dermatology Llc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate 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 1225417082, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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
2
Unchanged
Pos 3
2
Doubled → 4
Pos 4
5
Unchanged
Pos 5
4
Doubled → 8
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
0
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
2
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 2 → 4 4 → 8 7 → 14 → 5 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 4 + 5 + 8 + 1 + 1 + 4 + 0 + 1 + 6 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1225417082.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225417082, enumerated as an "organization" on May 27, 2015.

The provider is located at 44 A& B MEDICAL PARK BLVD PETERSBURG, VA 23805 and the phone number is (804) 648-4802.

Nurse Practitioner with taxonomy code 363L00000X.