FRUITLAND ORTHOPEDIC CLINIC
NPI 1710975057
Orthopaedic Surgery in Fruitland, ID
NPI Status: Active since October 11, 2005
Contact Information
1118 NW 16TH ST
SUITE C
FRUITLAND, ID
ZIP 83619
Phone: (208) 452-2510
Fax: (208) 452-2513
- Organization
- Orthopaedic Surgery
- CLIA Number: 13D2049635
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 04-22-2027
About FRUITLAND ORTHOPEDIC CLINIC
This page provides the complete NPI Profile along with additional information for Fruitland Orthopedic Clinic, a provider established in Fruitland, Idaho operating as a Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1710975057 assigned on October 2005. The practitioner's primary taxonomy code is 207X00000X with license number M-6608 (ID). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jan Olof Dahlin M.d. (Owner)
- NPI
- 1710975057
- Provider Name
- FRUITLAND ORTHOPEDIC CLINIC
- Entity Type
- Organization
- Location Address
- 1118 NW 16TH ST SUITE C FRUITLAND, ID 83619
- Location Phone
- (208) 452-2510
- Location Fax
- (208) 452-2513
- Mailing Address
- 1118 NW 16TH ST SUITE C FRUITLAND, ID 83619
- Mailing Phone
- (208) 452-2510
- Mailing Fax
- (208) 452-2513
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-11-2005
- Last Update Date
- 08-22-2020
- 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
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- M-6608
- License State
- ID
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
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 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | MD13079 (OR) |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 266148 | MEDICAID (05) | OR |
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
- 13D2049635
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- April 23, 2025
- Certificate Expiration Date
- April 22, 2027
- Laboratory Director
- ERIC RYSENGA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fruitland Orthopedic Clinic 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.
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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 1710975057, 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 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 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
FRUITLAND, ID 83619
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710975057, enumerated as an "organization" on October 11, 2005.
The provider is located at 1118 NW 16TH ST SUITE C FRUITLAND, ID 83619 and the phone number is (208) 452-2510.
Orthopaedic Surgery with taxonomy code 207X00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
