PROVIDENCE HOSPITAL
NPI 1710362496
General Acute Care Hospital in Southfield, MI

NPI Status: Active since July 23, 2015

Contact Information

16001 W 9 MILE RD
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 849-8902

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

Organization
General Acute Care Hospital
CLIA Number: 23D0706789
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 11-26-2025

About PROVIDENCE HOSPITAL

This page provides the complete NPI Profile along with additional information for Providence Hospital, a provider established in Southfield, Michigan operating as a General Acute Care Hospital. The healthcare provider is registered in the NPI registry with number 1710362496 assigned on July 2015. The practitioner's primary taxonomy code is 282N00000X with license number 4301108431 (MI). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Dr. Vijay Kumar Mittal Md (Program Director)

NPI: 1710362496
Provider Name: PROVIDENCE HOSPITAL
Entity Type: Organization
Location Address: 16001 W 9 MILE RD SOUTHFIELD, MI 48075
Location Phone: (248) 849-8902
Mailing Address: 16001 W 9 MILE RD SOUTHFIELD, MI 48075
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 07-23-2015
Last Update Date: 07-23-2015
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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: General Acute Care Hospital
Taxonomy Code: 282N00000X
Type: Hospitals
License No.: 4301108431
License State: MI
Taxonomy Description: An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

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: DR. VIJAY KUMAR MITTAL MD
Authorized Official Title: PROGRAM DIRECTOR
Authorized Official Phone: (248) 849-8902

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: 23D0706789
Facility Type: Physician Office
Certificate Effective Date: November 27, 2023
Certificate Expiration Date: November 26, 2025
Laboratory Director: WILLIAM C. SHARP
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Providence Hospital 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 Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	1	0	3	6	2	4	9	6
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	2	0	6	6	4	4	18
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 2 + 0 + 6 + 6 + 4 + 4 + 1 + 8 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 6									6

The NPI number 1710362496 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

MYRNA S DELEON MD

Pediatrics

(Pediatric Critical Care Medicine)

16001 W 9 MILE RD
SOUTHFIELD, MI
ZIP 48075

About PROVIDENCE HOSPITAL

Location Map

Specialty - Primary Taxonomy

General Acute Care Hospital

Authorized Official

DR. VIJAY KUMAR MITTAL MD

CLIA Information

Reviews for PROVIDENCE HOSPITAL

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

What is PROVIDENCE HOSPITAL's NPI number?

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What is the provider's specialty?