PREVENTIVE MEDICINE ANTI-AGING AND CHELATION, INC
NPI 1255879755
Point of Service in Ringgold, GA
NPI Status: Active since February 03, 2017
Contact Information
148 COBB PKWY
RINGGOLD, GA
ZIP 30736
Phone: (706) 891-1200
- Organization
- Point of Service
- CLIA Number: 44D0933587
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-16-2027
About PREVENTIVE MEDICINE ANTI-AGING AND CHELATION, INC
This page provides the complete NPI Profile along with additional information for Preventive Medicine Anti-aging And Chelation, Inc, a provider established in Ringgold, Georgia operating as a Point Of Service. The healthcare provider is registered in the NPI registry with number 1255879755 assigned on February 2017. The practitioner's primary taxonomy code is 305S00000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Dimitri Loucas (Billing)
- NPI
- 1255879755
- Provider Name
- PREVENTIVE MEDICINE ANTI-AGING AND CHELATION, INC
- Entity Type
- Organization
- Location Address
- 148 COBB PKWY RINGGOLD, GA 30736
- Location Phone
- (706) 891-1200
- Mailing Address
- 148 COBB PKWY RINGGOLD, GA 30736
- Mailing Phone
- (706) 891-1200
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-03-2017
- Last Update Date
- 02-03-2017
- Code Navigator
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
Point of Service
- Taxonomy Code
- 305S00000X
- Type
- Managed Care Organizations
- License State
- GA
- Taxonomy Description
- This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
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
- 44D0933587
- Facility Type
- Physician Office
- Certificate Effective Date
- June 17, 2025
- Certificate Expiration Date
- June 16, 2027
- Laboratory Director
- ROBERT BURKICH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Preventive Medicine Anti-aging And Chelation, Inc 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 1255879755, 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 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 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255879755, enumerated as an "organization" on February 03, 2017.
The provider is located at 148 COBB PKWY RINGGOLD, GA 30736 and the phone number is (706) 891-1200.
Point of Service with taxonomy code 305S00000X.
