AGNES STREET HOME FOR THE ELDERLY
NPI 1275970204
Assisted Living Facility in Jacksonville, FL

NPI Status: Active since May 31, 2013

Contact Information

1346 AGNES ST
JACKSONVILLE, FL
ZIP 32208
Phone: (904) 766-7651
Fax: (904) 766-7668

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  • Organization
  • Assisted Living Facility

About AGNES STREET HOME FOR THE ELDERLY

This page provides the complete NPI Profile along with additional information for Agnes Street Home For The Elderly, a provider established in Jacksonville, Florida operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1275970204 assigned on May 2013. The practitioner's primary taxonomy code is 310400000X with license number AL5745 (FL). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mr. Atakelte Admasu (Owner/administrator)

NPI
1275970204
Provider Name
AGNES STREET HOME FOR THE ELDERLY
Entity Type
Organization
Location Address
1346 AGNES ST JACKSONVILLE, FL 32208
Location Phone
(904) 766-7651
Location Fax
(904) 766-7668
Mailing Address
1346 AGNES ST JACKSONVILLE, FL 32208
Mailing Phone
(904) 766-7651
Mailing Fax
(904) 766-7668
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-31-2013
Last Update Date
05-31-2013
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
AL5745
License State
FL
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Insurance Plans Accepted

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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*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

MR. ATAKELTE ADMASU

Authorized Official Title
OWNER/ADMINISTRATOR
Authorized Official Phone
(904) 766-7651

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
142605200MEDICAID (05)FL 

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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 1275970204, 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
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
7
Unchanged
Pos 7
0
Doubled → 0
Pos 8
2
Unchanged
Pos 9
0
Doubled → 0
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 7 → 14 → 5 9 → 18 → 9 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 1 + 4 + 5 + 1 + 8 + 7 + 0 + 2 + 0 + 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 1275970204.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275970204, enumerated as an "organization" on May 31, 2013.

The provider is located at 1346 AGNES ST JACKSONVILLE, FL 32208 and the phone number is (904) 766-7651.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.