PRIVATE CLINIC NORTH
NPI 1669572335
Clinic/Center - Methadone in Rossville, GA

NPI Status: Active since September 23, 2006

Contact Information

822 CHICKAMAUGA AVE
ROSSVILLE, GA
ZIP 30741
Phone: (706) 861-6458
Fax: (706) 866-6277

NPI Profile Information
Primary Taxonomy
Authorized Official
Areas of Expertise
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center
Methadone
CLIA Number: 11D1042615
CLIA Cert. Type: Practitioner Other
CLIA Exp. Date: 07-04-2027

About PRIVATE CLINIC NORTH

This page provides the complete NPI Profile along with additional information for Private Clinic North, a provider established in Rossville, Georgia operating as a Clinic/center, focusing in methadone . The healthcare provider is registered in the NPI registry with number 1669572335 assigned on September 2006. The practitioner's primary taxonomy code is 261QM2800X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Private Clinic North. The authorized official of this NPI record is Mr. Douglas Stephen Davis Ccs, Cadc2, Cas (Administrator)

NPI: 1669572335
Provider Legal Name: NEPTUNE CLINICAL GROUP, INC.
Other Organization Name: PRIVATE CLINIC NORTH
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 822 CHICKAMAUGA AVE ROSSVILLE, GA 30741
Location Phone: (706) 861-6458
Location Fax: (706) 866-6277
Mailing Address: 822 CHICKAMAUGA AVE ROSSVILLE, GA 30741
Mailing Phone: (706) 861-6458
Mailing Fax: (706) 866-6277
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 09-23-2006
Last Update Date: 03-12-2020
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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: Clinic/Center Methadone
Taxonomy Code: 261QM2800X
Type: Ambulatory Health Care Facilities
Taxonomy Description: An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

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. DOUGLAS STEPHEN DAVIS CCS, CADC2, CAS
Authorized Official Title: ADMINISTRATOR
Authorized Official Phone: (706) 861-6458

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm
Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for
Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure

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: 11D1042615
Facility Type: Practitioner Other
Certificate Effective Date: July 05, 2025
Certificate Expiration Date: July 04, 2027
Laboratory Director: DOUGLAS STEPHEN DAVIS
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Private Clinic North 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 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 1669572335, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 10 → 1 + 0

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 6

Check

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 6 → 12 → 3 5 → 10 → 1 2 → 4 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 1 + 2 + 9 + 1 + 0 + 7 + 4 + 3 + 6 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5

This NPI is valid

The calculated check digit is 5, which matches the last digit of 1669572335.