BLUESTONE PHYSICIAN SERVICES SOUTHEAST LLC
NPI 1255945739
Family Medicine in Norfolk, VA

NPI Status: Active since September 02, 2020

Contact Information

999 WATERSIDE DR STE 2525
NORFOLK, VA
ZIP 23510
Phone: (757) 777-3433
Fax: (855) 818-3907

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  • Organization
  • Family Medicine
  • CLIA Number: 24D2082638
  • CLIA Cert. Type: Other - MOBILE PRIMARY CARE PRACT
  • CLIA Exp. Date: 10-19-2026

About BLUESTONE PHYSICIAN SERVICES SOUTHEAST LLC

This page provides the complete NPI Profile along with additional information for Bluestone Physician Services Southeast Llc, a primary care provider established in Norfolk, Virginia operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1255945739 assigned on September 2020. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 6 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 provider's former legal business name is Bluestone Physician Services Florida, Llc. The authorized official of this NPI record is Tim Koehler (Coo)

NPI
1255945739
Provider Legal Name
BLUESTONE PHYSICIAN SERVICES SOUTHEAST LLC
Other Organization Name
BLUESTONE PHYSICIAN SERVICES FLORIDA, LLC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
999 WATERSIDE DR STE 2525 NORFOLK, VA 23510
Location Phone
(757) 777-3433
Location Fax
(855) 818-3907
Mailing Address
270 MAIN ST N STE 300 STILLWATER, MN 55082
Mailing Phone
(651) 342-1039
Mailing Fax
(855) 818-3907
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-02-2020
Last Update Date
10-22-2020
Code Navigator

A primary care provider (PCP) like Bluestone Physician Services Southeast Llc 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.

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)
1208D00000XAllopathic & Osteopathic Physicians

General Practice

 

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

TIM KOEHLER

Authorized Official Title
COO
Authorized Official Phone
(651) 342-1039

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
24D2082638
Facility Type
Other - MOBILE PRIMARY CARE PRACT
Certificate Effective Date
October 20, 2024
Certificate Expiration Date
October 19, 2026
Laboratory Director
RAJIV PATEL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bluestone Physician Services Southeast Llc 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 1255945739, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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
9
Doubled → 18 → 1 + 8
Pos 6
4
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
7
Unchanged
Pos 9
3
Doubled → 6
Check
9
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 9 → 18 → 9 5 → 10 → 1 3 → 6

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 + 8 + 4 + 1 + 0 + 7 + 6 + 24 = 61

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

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1255945739.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Counselor (Addiction (Substance Use Disorder))
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Clinic/Center (Primary Care)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Driver
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Non-emergency Medical Transport (VAN)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Community/Behavioral Health
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Family Medicine
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Psychologist (Clinical)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Counselor (Addiction (Substance Use Disorder))
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
In Home Supportive Care
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Counselor (Addiction (Substance Use Disorder))
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Counselor (Mental Health)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Counselor (Mental Health)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Home Health
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Prosthetic/Orthotic Supplier
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Technician, Pathology (Phlebotomy)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Family Medicine
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Social Worker (Clinical)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Counselor
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Social Worker (Clinical)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Nurse Practitioner (Psychiatric/Mental Health)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255945739, enumerated as an "organization" on September 02, 2020.

The provider is located at 999 WATERSIDE DR STE 2525 NORFOLK, VA 23510 and the phone number is (757) 777-3433.

Family Medicine with taxonomy code 207Q00000X.