PANACEA BRAIN AND SPINE, LLC
NPI 1457622763
Neurological Surgery in Lake Havasu City, AZ
NPI Status: Active since January 18, 2012
Contact Information
72 LAKE HAVASU AVE S STE 102
LAKE HAVASU CITY, AZ
ZIP 86403
Phone: (928) 453-2211
Fax: (928) 453-2213
- Organization
- Neurological Surgery
- CLIA Number: 03D2048793
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-22-2026
About PANACEA BRAIN AND SPINE, LLC
This page provides the complete NPI Profile along with additional information for Panacea Brain And Spine, Llc, a provider established in Lake Havasu City, Arizona operating as a Neurological Surgery. The healthcare provider is registered in the NPI registry with number 1457622763 assigned on January 2012. The practitioner's primary taxonomy code is 207T00000X with license number 46605 (AZ). The provider is registered as an organization and their NPI record was last updated 6 years ago. Panacea Brain And Spine, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Chad Hartley Md (Owner)
- NPI
- 1457622763
- Provider Name
- PANACEA BRAIN AND SPINE, LLC
- Entity Type
- Organization
- Location Address
- 72 LAKE HAVASU AVE S STE 102 LAKE HAVASU CITY, AZ 86403
- Location Phone
- (928) 453-2211
- Location Fax
- (928) 453-2213
- Mailing Address
- 72 LAKE HAVASU AVE S STE 102 LAKE HAVASU CITY, AZ 86403
- Mailing Phone
- (928) 453-2211
- Mailing Fax
- (928) 453-2213
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-18-2012
- Last Update Date
- 06-29-2020
- Code Navigator
Location Map
Secondary Locations
- 13677 W McDowell Rd
Goodyear, AZ 85395
(928) 453-2211 - 1200 W Mohave Rd
Parker, AZ 85344
(928) 453-2211
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
Neurological Surgery
- Taxonomy Code
- 207T00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 46605
- License State
- AZ
- Taxonomy Description
- A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
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
- 03D2048793
- Facility Type
- Physician Office
- Certificate Effective Date
- October 23, 2024
- Certificate Expiration Date
- October 22, 2026
- Laboratory Director
- CHAD E. HARTLEY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Panacea Brain And Spine, Llc 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 1457622763, 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.
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 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
LAKE HAVASU CITY, AZ 86403
LAKE HAVASU CITY, AZ 86403
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457622763, enumerated as an "organization" on January 18, 2012.
The provider is located at 72 LAKE HAVASU AVE S STE 102 LAKE HAVASU CITY, AZ 86403 and the phone number is (928) 453-2211.
Neurological Surgery with taxonomy code 207T00000X.
