TYLER 1 VA CLINIC
NPI 1629459730
Clinic/Center - VA in Tyler, TX

NPI Status: Active since June 15, 2015

Contact Information

7916 S BROADWAY AVE STE 100
TYLER, TX
ZIP 75703
Phone: (615) 355-3451

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  • Organization
  • Clinic/Center
  • VA
  • Accepts Insurance
  • CLIA Number: 45D1072466
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 05-22-2026

About TYLER 1 VA CLINIC

This page provides the complete NPI Profile along with additional information for Tyler 1 Va Clinic, a provider established in Tyler, Texas operating as a Clinic/center, focusing in va . The healthcare provider is registered in the NPI registry with number 1629459730 assigned on June 2015. The practitioner's primary taxonomy code is 261QV0200X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's other name is Tyler 1 Va Clinic. The authorized official of this NPI record is Erin Potter (Npi Team Member)

NPI
1629459730
Provider Legal Name
DALLAS VAMC
Other Organization Name
TYLER 1 VA CLINIC
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
7916 S BROADWAY AVE STE 100 TYLER, TX 75703
Location Phone
(615) 355-3451
Mailing Address
PO BOX 94493 CLEVELAND, OH 44101
Mailing Phone
(615) 355-3451
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-15-2015
Last Update Date
08-30-2022
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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

Clinic/Center VA

Taxonomy Code
261QV0200X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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
45D1072466
Facility Type
Community Clinic
Certificate Effective Date
August 17, 2007
Certificate Expiration Date
May 22, 2026
Laboratory Director
SHELBY MELTON
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Tyler 1 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.

Reviews for TYLER 1 VA CLINIC

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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 1629459730, we treat the final digit (0) 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 80. The final step is to find the difference between that total and the next multiple of ten (80 - 80 = 0).

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
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
4
Doubled → 8
Pos 6
5
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
7
Unchanged
Pos 9
3
Doubled → 6
Check
0
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 2 → 4 4 → 8 9 → 18 → 9 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 4 + 9 + 8 + 5 + 1 + 8 + 7 + 6 + 24 = 80

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

The next multiple of ten after 80 is 80. The difference is the calculated check digit.

80 - 80 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1629459730.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Respiratory Therapist, Registered (General Care)
7916 S BROADWAY AVE STE 100
TYLER, TX 75703

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629459730, enumerated as an "organization" on June 15, 2015.

The provider is located at 7916 S BROADWAY AVE STE 100 TYLER, TX 75703 and the phone number is (615) 355-3451.

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

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas. Please consult your insurance carrier or call the provider to verify.