TRADITIONS OF FREDERIC
NPI 1588089114
Assisted Living Facility in Frederic, WI

NPI Status: Active since February 18, 2014

Contact Information

107 OAK ST E
FREDERIC, WI
ZIP 54837
Phone: (715) 327-4888

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 52D2074491
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 03-10-2028

About TRADITIONS OF FREDERIC

This page provides the complete NPI Profile along with additional information for Traditions Of Frederic, a provider established in Frederic, Wisconsin operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1588089114 assigned on February 2014. The practitioner's primary taxonomy code is 310400000X with license number 0013890 (WI). The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Mr. Andrew Mayo M.d. (Owner)

NPI
1588089114
Provider Name
TRADITIONS OF FREDERIC
Entity Type
Organization
Location Address
107 OAK ST E FREDERIC, WI 54837
Location Phone
(715) 327-4888
Mailing Address
107 OAK ST E FREDERIC, WI 54837
Mailing Phone
(715) 327-4889
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-18-2014
Last Update Date
06-30-2015
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
0013890
License State
WI
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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

MR. ANDREW MAYO M.D.

Authorized Official Title
OWNER
Authorized Official Phone
(715) 497-6101

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
52D2074491
Facility Type
Assisted Living Facility
Certificate Effective Date
March 11, 2026
Certificate Expiration Date
March 10, 2028
Laboratory Director
SAM NEURER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Traditions Of Frederic 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 1588089114, 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 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
5
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
8
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
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 0 → 0 9 → 18 → 9 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 1 + 6 + 8 + 0 + 8 + 1 + 8 + 1 + 2 + 24 = 66

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

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1588089114.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1588089114, enumerated as an "organization" on February 18, 2014.

The provider is located at 107 OAK ST E FREDERIC, WI 54837 and the phone number is (715) 327-4888.

Assisted Living Facility with taxonomy code 310400000X.