IDRIS ROBERSON
NPI 1639957277
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Glendale, AZ
NPI Status: Active since September 15, 2023
Contact Information
4494 W PEORIA AVE STE 101
GLENDALE, AZ
ZIP 85302
Phone: (602) 687-2043
Fax: (623) 440-4285
- Individual
- Male
- Community Based Residential Treatment Fa...
About IDRIS ROBERSON
This page provides the complete NPI Profile along with additional information for Idris Roberson, a provider established in Glendale, Arizona with a medical specialization in Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1639957277 assigned on September 2023. The practitioner's primary taxonomy code is 320900000X with license number 221509-14979 (AZ). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1639957277
- Provider Name
- IDRIS ROBERSON
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4494 W PEORIA AVE STE 101 GLENDALE, AZ 85302
- Location Phone
- (602) 687-2043
- Location Fax
- (623) 440-4285
- Mailing Address
- 4494 W PEORIA AVE STE 101 GLENDALE, AZ 85302
- Mailing Phone
- (602) 687-2043
- Mailing Fax
- (623) 440-4285
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 09-15-2023
- Last Update Date
- 09-15-2023
- Code Navigator
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
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320900000X
- Type
- Residential Treatment Facilities
- License No.
- 221509-14979
- License State
- AZ
- Taxonomy Description
- A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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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 1639957277, we treat the final digit (7) 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 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639957277, enumerated as an "individual" on September 15, 2023.
The provider is located at 4494 W PEORIA AVE STE 101 GLENDALE, AZ 85302 and the phone number is (602) 687-2043.
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.
