MEMORIAL PEDIATRICS
NPI 1629596853
Clinic/Center - Multi-Specialty in Bainbridge, GA

NPI Status: Active since September 08, 2017

Contact Information

603 WHEAT AVE STE 450
BAINBRIDGE, GA
ZIP 39819
Phone: (229) 243-7707

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  • Organization
  • Clinic/Center
  • Multi-Specialty
  • CLIA Number: 11D0958567
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-07-2027

About MEMORIAL PEDIATRICS

This page provides the complete NPI Profile along with additional information for Memorial Pediatrics, a provider established in Bainbridge, Georgia operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1629596853 assigned on September 2017. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Memorial Pediatrics. The authorized official of this NPI record is Karen Faircloth (Cfo)

NPI
1629596853
Provider Legal Name
HOSPITAL AUTHORITY OF THE CITY OF BAINBRIDGE AND DECATUR COUNTY GEORGI
Other Organization Name
MEMORIAL PEDIATRICS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
603 WHEAT AVE STE 450 BAINBRIDGE, GA 39819
Location Phone
(229) 243-7707
Mailing Address
1500 E SHOTWELL ST BAINBRIDGE, GA 39819
Mailing Phone
(229) 243-1700
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-08-2017
Last Update Date
09-08-2017
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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 Multi-Specialty

Taxonomy Code
261QM1300X
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

KAREN FAIRCLOTH

Authorized Official Title
CFO
Authorized Official Phone
(229) 246-8211

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
11D0958567
Facility Type
Physician Office
Certificate Effective Date
February 08, 2025
Certificate Expiration Date
February 07, 2027
Laboratory Director
DR. MANDY S. MOYE
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Memorial Pediatrics in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate 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 1629596853, 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 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.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
9
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
8
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
3
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 5 → 10 → 1 6 → 12 → 3 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 4 + 9 + 1 + 0 + 9 + 1 + 2 + 8 + 1 + 0 + 24 = 67

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

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1629596853.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Pediatrics
603 WHEAT AVE STE 450
BAINBRIDGE, GA 39819
Nurse Practitioner (Family)
603 WHEAT AVE STE 450
BAINBRIDGE, GA 39819
Pediatrics
603 WHEAT AVE STE 450
BAINBRIDGE, GA 39819

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629596853, enumerated as an "organization" on September 08, 2017.

The provider is located at 603 WHEAT AVE STE 450 BAINBRIDGE, GA 39819 and the phone number is (229) 243-7707.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.