MATHIESEN MEMORIAL HEALTH CLINIC
NPI 1255595484
Clinic/Center - Federally Qualified Health Center (FQHC) in Jamestown, CA

NPI Status: Active since July 16, 2008

Contact Information

18144 SECO ST
JAMESTOWN, CA
ZIP 95327
Phone: (209) 984-4820
Fax: (209) 984-4825

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)
  • CLIA Number: 05D1088264
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-19-2026

About MATHIESEN MEMORIAL HEALTH CLINIC

This page provides the complete NPI Profile along with additional information for Mathiesen Memorial Health Clinic, a primary care provider established in Jamestown, California operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1255595484 assigned on July 2008. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Jacqueline Kiss (Credentialing)

NPI
1255595484
Provider Name
MATHIESEN MEMORIAL HEALTH CLINIC
Entity Type
Organization
Location Address
18144 SECO ST JAMESTOWN, CA 95327
Location Phone
(209) 984-4820
Location Fax
(209) 984-4825
Mailing Address
PO BOX 535 JAMESTOWN, CA 95327
Mailing Phone
(209) 984-4820
Mailing Fax
(209) 984-4825
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-16-2008
Last Update Date
07-25-2023
Code Navigator

A primary care provider (PCP) like Mathiesen Memorial Health 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

Secondary Locations

  • 18232 Smoke St
    Jamestown, CA 95327
    (209) 984-4820
  • 18158 Main St
    Jamestown, CA 95327
    (209) 984-4820
  • 18268 Main St
    Jamestown, CA 95327
    (209) 984-4820

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 Federally Qualified Health Center (FQHC)

Taxonomy Code
261QF0400X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QM1300XAmbulatory Health Care Facilities

Clinic/Center
Multi-Specialty

 
2261QP2300XAmbulatory Health Care Facilities

Clinic/Center
Primary Care

 

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

JACQUELINE KISS

Authorized Official Title
CREDENTIALING
Authorized Official Phone
(254) 760-0228

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
05D1088264
Facility Type
Physician Office
Certificate Effective Date
August 20, 2024
Certificate Expiration Date
August 19, 2026
Laboratory Director
DANIEL FUROY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mathiesen Memorial Health Clinic 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 1255595484, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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
5
Doubled → 10 → 1 + 0
Pos 4
5
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
9
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
4
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 5 → 10 → 1 5 → 10 → 1 5 → 10 → 1 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 + 1 + 0 + 5 + 1 + 0 + 9 + 1 + 0 + 4 + 1 + 6 + 24 = 56

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

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1255595484.

Other Providers at the Same Location


The following 15 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
18144 SECO ST
JAMESTOWN, CA 95327
Marriage & Family Therapist
18144 SECO ST
JAMESTOWN, CA 95327
General Practice
18144 SECO ST, MATHIESEN MEMORIAL HEALTH CLINIC
JAMESTOWN, CA 95327
Nurse Practitioner (Family)
18144 SECO ST
JAMESTOWN, CA 95327
Physician Assistant
18144 SECO ST
JAMESTOWN, CA 95327
Physician Assistant
18144 SECO ST
JAMESTOWN, CA 95327
Nurse Practitioner (Family)
18144 SECO ST
JAMESTOWN, CA 95327
General Practice
18144 SECO ST
JAMESTOWN, CA 95327
Nurse Practitioner (Family)
18144 SECO ST
JAMESTOWN, CA 95327
Physician Assistant
18144 SECO ST
JAMESTOWN, CA 95327
Clinic/Center (Primary Care)
18144 SECO ST
JAMESTOWN, CA 95327
Physician Assistant
18144 SECO ST
JAMESTOWN, CA 95327
Nurse Practitioner
18144 SECO ST
JAMESTOWN, CA 95327
Marriage & Family Therapist
18144 SECO ST
JAMESTOWN, CA 95327
Dental Hygienist
18144 SECO ST
JAMESTOWN, CA 95327

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255595484, enumerated as an "organization" on July 16, 2008.

The provider is located at 18144 SECO ST JAMESTOWN, CA 95327 and the phone number is (209) 984-4820.

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).