NORTSIDE MEDICAL CLINIC, P.A.
NPI 1285755504
Family Medicine in Fort Worth, TX

NPI Status: Active since April 03, 2007

Contact Information

1600 25TH STREET
SUITE B
FORT WORTH, TX
ZIP 76106
Phone: (817) 626-3434

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  • Organization
  • Family Medicine
  • CLIA Number: 45D0920264
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-20-2027

About NORTSIDE MEDICAL CLINIC, P.A.

This page provides the complete NPI Profile along with additional information for Nortside Medical Clinic, P.a., a primary care provider established in Fort Worth, Texas operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1285755504 assigned on April 2007. 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 authorized official of this NPI record is Bruce E. Wardlay D.o. (Owner)

NPI
1285755504
Provider Name
NORTSIDE MEDICAL CLINIC, P.A.
Entity Type
Organization
Location Address
1600 25TH STREET SUITE B FORT WORTH, TX 76106
Location Phone
(817) 626-3434
Mailing Address
1600 25TH STREET SUITE B FORT WORTH, TX 76106
Mailing Phone
(817) 626-3434
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-03-2007
Last Update Date
08-22-2020
Code Navigator

A primary care provider (PCP) like Nortside Medical Clinic, P.a. 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.

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

BRUCE E. WARDLAY D.O.

Authorized Official Title
OWNER
Authorized Official Phone
(817) 626-3434

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
45D0920264
Facility Type
Physician Office
Certificate Effective Date
January 21, 2025
Certificate Expiration Date
January 20, 2027
Laboratory Director
ROBERT CAMPBELL,MD
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Nortside Medical Clinic, P.a. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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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 1285755504, 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
8
Doubled → 16 → 1 + 6
Pos 4
5
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
5
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
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 8 → 16 → 7 7 → 14 → 5 5 → 10 → 1 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 + 6 + 5 + 1 + 4 + 5 + 1 + 0 + 5 + 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 1285755504.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285755504, enumerated as an "organization" on April 03, 2007.

The provider is located at 1600 25TH STREET SUITE B FORT WORTH, TX 76106 and the phone number is (817) 626-3434.

Family Medicine with taxonomy code 207Q00000X.