MEMORIAL MEDICAL AUGUSTA CLINIC
NPI 1275979031
Nurse Practitioner - Family in Augusta, IL
NPI Status: Active since May 20, 2013
Contact Information
204 CENTER ST
AUGUSTA, IL
ZIP 62311
Phone: (217) 392-2108
Fax: (217) 392-2110
- Organization
- Nurse Practitioner
- Family
- CLIA Number: 14D0902431
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-27-2027
About MEMORIAL MEDICAL AUGUSTA CLINIC
This page provides the complete NPI Profile along with additional information for Memorial Medical Augusta Clinic, a provider established in Augusta, Illinois operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1275979031 assigned on May 2013. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. Memorial Medical Augusta Clinic operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Memorial Medical Augusta Clinic. The authorized official of this NPI record is Jessie Fifer (Special Projects Coordinator)
- NPI
- 1275979031
- Provider Legal Name
- MEMORIAL HOSPITAL ASSOCIATION
- Other Organization Name
- MEMORIAL MEDICAL AUGUSTA CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 204 CENTER ST AUGUSTA, IL 62311
- Location Phone
- (217) 392-2108
- Location Fax
- (217) 392-2110
- Mailing Address
- PO BOX 160 CARTHAGE, IL 62321
- Mailing Phone
- (217) 357-6512
- Mailing Fax
- (217) 392-2110
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-20-2013
- Last Update Date
- 05-20-2013
- Code Navigator
A nurse practitioner (NP) like Memorial Medical Augusta Clinic is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, 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
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
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) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
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.
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
- 14D0902431
- Facility Type
- Physician Office
- Certificate Effective Date
- April 28, 2025
- Certificate Expiration Date
- April 27, 2027
- Laboratory Director
- CHRISTOPHER JONES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Memorial Medical Augusta 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 1275979031, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
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 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275979031, enumerated as an "organization" on May 20, 2013.
The provider is located at 204 CENTER ST AUGUSTA, IL 62311 and the phone number is (217) 392-2108.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
