LAKE KIOWA MEDICAL CLINIC
NPI 1235697350
Family Medicine in Gainesville, TX

NPI Status: Active since March 07, 2019

Contact Information

100 KIOWA DR W APT 103
GAINESVILLE, TX
ZIP 76240
Phone: (940) 612-5562
Fax: (940) 665-6201

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  • Organization
  • Family Medicine
  • Accepts Insurance
  • CLIA Number: 45D0998159
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 04-07-2028

About LAKE KIOWA MEDICAL CLINIC

This page provides the complete NPI Profile along with additional information for Lake Kiowa Medical Clinic, a primary care provider established in Gainesville, Texas operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1235697350 assigned on March 2019. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Lake Kiowa Medical Clinic operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Holly Oliveira Fnp (Owner)

NPI
1235697350
Provider Name
LAKE KIOWA MEDICAL CLINIC
Entity Type
Organization
Location Address
100 KIOWA DR W APT 103 GAINESVILLE, TX 76240
Location Phone
(940) 612-5562
Location Fax
(940) 665-6201
Mailing Address
PO BOX 1358 GAINESVILLE, TX 76241
Mailing Phone
(940) 612-5562
Mailing Fax
(940) 665-6201
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-07-2019
Last Update Date
08-28-2024
Code Navigator

A primary care provider (PCP) like Lake Kiowa Medical Clinic 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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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

HOLLY OLIVEIRA FNP

Authorized Official Title
OWNER
Authorized Official Phone
(940) 612-5562

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
45D0998159
Facility Type
Physician Office
Certificate Effective Date
April 08, 2026
Certificate Expiration Date
April 07, 2028
Laboratory Director
ROBERT R. MCLEROY MD
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Lake Kiowa Medical Clinic 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 1235697350, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

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
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
9
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
0
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 3 → 6 6 → 12 → 3 7 → 14 → 5 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 6 + 5 + 1 + 2 + 9 + 1 + 4 + 3 + 1 + 0 + 24 = 60

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

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

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1235697350.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235697350, enumerated as an "organization" on March 07, 2019.

The provider is located at 100 KIOWA DR W APT 103 GAINESVILLE, TX 76240 and the phone number is (940) 612-5562.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas. Please consult your insurance carrier or call the provider to verify.