PROMEDICA HEALTH SYSTEM
NPI 1285172163
Physician Assistant - Medical in Sylvania, OH

NPI Status: Active since February 10, 2017

Contact Information

5308 HARROUN RD STE 280
SYLVANIA, OH
ZIP 43560
Phone: (419) 824-1785
Fax: (419) 824-5953

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  • Organization
  • Physician Assistant
  • Medical
  • CLIA Number: 36D1052073
  • CLIA Cert. Type: Other - OCCUPATIONAL MEDICAL CLIN
  • CLIA Exp. Date: 03-15-2028

About PROMEDICA HEALTH SYSTEM

This page provides the complete NPI Profile along with additional information for Promedica Health System, a primary care provider established in Sylvania, Ohio operating as a Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1285172163 assigned on February 2017. The practitioner's primary taxonomy code is 363AM0700X with license number 50.004996RX (OH). The provider is registered as an organization and their NPI record was last updated 9 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 authorized official of this NPI record is Courtney Moyer Pa-c, Rd, Ld (Physician Assistant)

NPI
1285172163
Provider Name
PROMEDICA HEALTH SYSTEM
Entity Type
Organization
Location Address
5308 HARROUN RD STE 280 SYLVANIA, OH 43560
Location Phone
(419) 824-1785
Location Fax
(419) 824-5953
Mailing Address
157 N STATE ROUTE 510 FREMONT, OH 43420
Mailing Phone
(419) 217-1614
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-10-2017
Last Update Date
02-10-2017
Code Navigator

A primary care provider (PCP) like Promedica Health System 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

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
50.004996RX
License State
OH

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

COURTNEY MOYER PA-C, RD, LD

Authorized Official Title
PHYSICIAN ASSISTANT
Authorized Official Phone
(419) 824-1785

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
36D1052073
Facility Type
Other - OCCUPATIONAL MEDICAL CLIN
Certificate Effective Date
March 16, 2026
Certificate Expiration Date
March 15, 2028
Laboratory Director
LAWRENCE A. KALE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Promedica Health System 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 1285172163, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

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
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
3
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 8 → 16 → 7 1 → 2 2 → 4 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 1 + 6 + 5 + 2 + 7 + 4 + 1 + 1 + 2 + 24 = 57

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

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1285172163.

Other Providers at the Same Location


The following 9 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Physician Assistant
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Physician Assistant
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Physician Assistant
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Surgery (Plastic and Reconstructive Surgery)
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Plastic Surgery
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Physician Assistant
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Nurse Practitioner
5308 HARROUN RD STE 280
SYLVANIA, OH 43560
Obstetrics & Gynecology (Gynecologic Oncology)
5308 HARROUN RD STE 280
SYLVANIA, OH 43560

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285172163, enumerated as an "organization" on February 10, 2017.

The provider is located at 5308 HARROUN RD STE 280 SYLVANIA, OH 43560 and the phone number is (419) 824-1785.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.