POCATELLO VA CLINIC
NPI 1487691002
Clinic/Center - VA in Pocatello, ID

NPI Status: Active since June 01, 2006

Contact Information

500 S 11TH AVE
POCATELLO, ID
ZIP 83201
Phone: (913) 578-4409

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  • Organization
  • Clinic/Center
  • VA
  • CLIA Number: 13D1013966
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 05-22-2026

About POCATELLO VA CLINIC

This page provides the complete NPI Profile along with additional information for Pocatello Va Clinic, a provider established in Pocatello, Idaho operating as a Clinic/center, focusing in va . The healthcare provider is registered in the NPI registry with number 1487691002 assigned on June 2006. The practitioner's primary taxonomy code is 261QV0200X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's other name is Pocatello Va Clinic. The authorized official of this NPI record is Erin Potter (Npi Team Member)

NPI
1487691002
Provider Legal Name
SALT LAKE CITY VAMC
Other Organization Name
POCATELLO VA CLINIC
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
500 S 11TH AVE POCATELLO, ID 83201
Location Phone
(913) 578-4409
Mailing Address
PO BOX 94463 CLEVELAND, OH 44101
Mailing Phone
(913) 578-4409
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-01-2006
Last Update Date
03-08-2018
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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

Clinic/Center VA

Taxonomy Code
261QV0200X
Type
Ambulatory Health Care Facilities

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

ERIN POTTER

Authorized Official Title
NPI TEAM MEMBER
Authorized Official Phone
(202) 382-2579

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
13D1013966
Facility Type
Community Clinic
Certificate Effective Date
June 23, 2003
Certificate Expiration Date
May 22, 2026
Laboratory Director
KANE WALSH
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Pocatello Va Clinic on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha 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 1487691002, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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
4
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
7
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
9
Unchanged
Pos 7
1
Doubled → 2
Pos 8
0
Unchanged
Pos 9
0
Doubled → 0
Check
2
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 6 → 12 → 3 1 → 2 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 1 + 6 + 7 + 1 + 2 + 9 + 2 + 0 + 0 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1487691002.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
500 S 11TH AVE, SUITE 305
POCATELLO, ID 83201
Internal Medicine (Pulmonary Disease)
500 S 11TH AVE, SUITE 305
POCATELLO, ID 83201
Psychiatry & Neurology (Psychiatry)
500 S 11TH AVE
POCATELLO, ID 83201
Specialist
500 S 11TH AVE
POCATELLO, ID 83201
Neurological Surgery
500 S 11TH AVE, SUITE 504
POCATELLO, ID 83201
Radiology (Radiation Oncology)
500 S 11TH AVE, SUITE 101
POCATELLO, ID 83201
Allergy & Immunology (Allergy)
500 S 11TH AVE, SUITE 202
POCATELLO, ID 83201
Advanced Practice Midwife
500 S 11TH AVE, SUITE 402
POCATELLO, ID 83201
Nurse Practitioner (Women's Health)
500 S 11TH AVE, SUITE 4G
POCATELLO, ID 83201
Internal Medicine
500 S 11TH AVE, SUITE 203
POCATELLO, ID 83201
Internal Medicine
500 S 11TH AVE, SUITE 203
POCATELLO, ID 83201
Surgery
500 S 11TH AVE, STE 501
POCATELLO, ID 83201
Counselor (Mental Health)
500 S 11TH AVE, SUITE 302
POCATELLO, ID 83201
Psychologist (Clinical)
500 S 11TH AVE, SUITE 302
POCATELLO, ID 83201
Psychologist (Clinical)
500 S 11TH AVE, SUITE 302
POCATELLO, ID 83201
Radiology (Radiation Oncology)
500 S 11TH AVE, SUITE 101
POCATELLO, ID 83201
Rehabilitation Counselor
500 S 11TH AVE, SUITE 302
POCATELLO, ID 83201
Dermatology
500 S 11TH AVE, SUITE 203
POCATELLO, ID 83201
Durable Medical Equipment & Medical Supplies
500 S 11TH AVE, STE 204
POCATELLO, ID 83201
Physician Assistant
500 S 11TH AVE, SUITE 503
POCATELLO, ID 83201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487691002, enumerated as an "organization" on June 01, 2006.

The provider is located at 500 S 11TH AVE POCATELLO, ID 83201 and the phone number is (913) 578-4409.

Clinic/Center with taxonomy code 261QV0200X and a focus in VA.