HEIDI CLINIC (THE HEIDI GROUP) NPI 1588018394

Clinic/Center (Family Planning, Non-Surgical) in Round Rock, TX

NPI 1588018394 Organization Clinic/Center Family Planning, Non-Surgical CLIA Number 45D2140523 CLIA Certificate of Waiver

About HEIDI CLINIC (THE HEIDI GROUP)

Heidi Clinic (the Heidi Group) is a provider established in Round Rock, Texas specializing in clinic/center (family planning, non-surgical) . The NPI number of Heidi Clinic (the Heidi Group) is 1588018394 and was assigned on April 2016. The practitioner's primary taxonomy code is 261QF0050X with license number G1054 (TX). The provider is registered as an organization and their NPI record was last updated 4 years ago. Heidi Clinic (the Heidi Group) operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's other name is Heidi Clinic. The authorized official of this NPI record is Mrs. Carol Everett (Ceo)

The CLIA number of Heidi Clinic is 45D2140523 registered as a "community clinic" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Heidi Clinic 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.

NPI

1588018394

Provider NameHEIDI CLINIC (THE HEIDI GROUP)
Provider Location Address894 SUMMIT ST STE 108 ROUND ROCK, TX 78664
Provider Mailing Address894 SUMMIT ST STE 108 ROUND ROCK, TX 78664
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameHEIDI CLINIC
Other Name TypeOther Name (5)
Enumeration Date04-18-2016
Last Update Date05-15-2018


Primary Taxonomy

Taxonomy Code261QF0050X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationFamily Planning, Non-Surgical
License No.G1054
License StateTX
Taxonomy DescriptionAn entity, facility, or distinct part of a facility, or mobile unit providing non-surgical, family planning/reproductive services including physical examination, laboratory services such as PAP or pregnancy tests; pregnancy, pregnancy prevention/contraceptive, and nutritional counseling, and contraceptives or prescriptions for contraceptives.

Business Address

HEIDI CLINIC
894 SUMMIT ST STE 108
ROUND ROCK, TX
ZIP 78664
Phone: (512) 255-2088
Fax: (512) 255-2582

Get Directions


Mailing Address

HEIDI CLINIC
894 SUMMIT ST STE 108
ROUND ROCK, TX
ZIP 78664
Phone: (512) 255-2088
Fax: (512) 255-2582



Authorized Official

Authorized Official NameMRS. CAROL EVERETT
Authorized Official TitleCEO
Authorized Official Phone(512) 255-2088

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 the NPI number 1588018394 is:

CLIA Number45D2140523
Facility TypeCOMMUNITY CLINIC
Certificate TypeCertificate of Waiver

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.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineNo

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.

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1912564121 EMILY CAROL CARDER WHNP-BC
Individual
Nurse Practitioner (Women's Health)894 SUMMIT ST STE 108
ROUND ROCK, TX 78664
(512) 255-2088

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.