PRAIRIE PEDIATRICS & ADOLESCENT CLINIC, PC
NPI 1306920319
Pediatrics - Pediatric Cardiology in Sioux City, IA
NPI Status: Active since October 25, 2006
Contact Information
1125 PIERCE ST
SIOUX CITY, IA
ZIP 51105
Phone: (712) 255-8901
Fax: (712) 255-9161
- Organization
- Pediatrics
- Pediatric Cardiology
- Accepts Insurance
- CLIA Number: 16D0385234
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-31-2026
About PRAIRIE PEDIATRICS & ADOLESCENT CLINIC, PC
This page provides the complete NPI Profile along with additional information for Prairie Pediatrics & Adolescent Clinic, Pc, a pediatrician established in Sioux City, Iowa operating as a Pediatrics, focusing in pediatric cardiology . The healthcare provider is registered in the NPI registry with number 1306920319 assigned on October 2006. The practitioner's primary taxonomy code is 2080P0202X. The provider is registered as an organization and their NPI record was last updated 11 years ago. Prairie Pediatrics & Adolescent Clinic, Pc 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 Prairie Pediatrics & Adolescent Clinic, Pc. The authorized official of this NPI record is Melanie Olsen (Business Manager)
- NPI
- 1306920319
- Provider Legal Name
- PRAIRIE PEDIATRICS, PC
- Other Organization Name
- PRAIRIE PEDIATRICS & ADOLESCENT CLINIC, PC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1125 PIERCE ST SIOUX CITY, IA 51105
- Location Phone
- (712) 255-8901
- Location Fax
- (712) 255-9161
- Mailing Address
- 1125 PIERCE ST SIOUX CITY, IA 51105
- Mailing Phone
- (712) 255-8901
- Mailing Fax
- (712) 255-9161
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-25-2006
- Last Update Date
- 01-27-2015
- Code Navigator
A pediatrician like Prairie Pediatrics & Adolescent Clinic, Pc is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, 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
Pediatrics Pediatric Cardiology
- Taxonomy Code
- 2080P0202X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Sanford Individual Simplicity $1,750 - PPO
- Sanford Individual Simplicity $10,600 - PPO
- Sanford Individual Simplicity $3,500 - PPO
- Sanford Individual Simplicity $4,750 - PPO
- Sanford Individual Simplicity $6,500 - PPO
- Sanford Individual Simplicity $7,200 HSA Qualified - PPO
- Sanford Individual Simplicity Standardized $2,000 - PPO
- Sanford Individual Simplicity Standardized $6,000 - PPO
- Sanford Individual Simplicity Standardized $7,500 - PPO
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.
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.
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 |
|---|---|---|---|
| 51104A001 | OTHER (01) | IA | TRICARE ENTITY ID |
| 71992 | MEDICARE PIN (08) | IA |
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
- 16D0385234
- Facility Type
- Physician Office
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- DR. RAY C. STURDEVANT
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Prairie Pediatrics & Adolescent Clinic, Pc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate 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 1306920319, 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 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 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.
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 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306920319, enumerated as an "organization" on October 25, 2006.
The provider is located at 1125 PIERCE ST SIOUX CITY, IA 51105 and the phone number is (712) 255-8901.
Pediatrics with taxonomy code 2080P0202X and a focus in Pediatric Cardiology.
The provider might be accepting Accepts: Sanford Health Plan, Tricare, Medicare and. Please consult your insurance carrier or call the provider to verify.
