ROANOKE CLINIC NPI 1720198369

Clinic/Center - Rural Health in Roanoke Rapids, NC

Organization Clinic/Center Rural Health CLIA Number 34D0701413 CLIA Certificate of Waiver

About ROANOKE CLINIC

Roanoke Clinic is a primary care provider established in Roanoke Rapids, North Carolina specializing in Clinic/center with a focus in rural health . The NPI number of Roanoke Clinic is 1720198369 and was assigned on August 2006. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated one year ago. Roanoke Clinic operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Roanoke Clinic. The authorized official of this NPI record is Mr. Jason Barnes Harrell (President)

A primary care provider (PCP) like Roanoke Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

The CLIA number of Roanoke Clinic is 34D0701413 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Roanoke 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.

NPI

1720198369

Provider NameROANOKE CLINIC
Provider Location Address1385 MEDICAL CENTER DR ROANOKE RAPIDS, NC 27870
Provider Mailing Address1385 MEDICAL CENTER DR ROANOKE RAPIDS, NC 27870
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameROANOKE CLINIC
Other Name TypeDoing Business As (3)
Enumeration Date08-30-2006
Last Update Date10-19-2021


Primary Taxonomy

Taxonomy Code261QR1300X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationRural Health

Business Address

ROANOKE CLINIC
1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC
ZIP 27870
Phone: (252) 537-9176
Fax: (252) 537-6851

Get Directions


Mailing Address

ROANOKE CLINIC
1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC
ZIP 27870
Phone: (252) 537-9176
Fax: (252) 537-6851


Authorized Official

Authorized Official NameMR. JASON BARNES HARRELL
Authorized Official TitlePRESIDENT
Authorized Official Phone(252) 535-8159

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 the NPI number 1720198369 is:

CLIA Number34D0701413
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X 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.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineNo

Taxonomy Description: family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
348941AMEDICAID (05)NC

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.
1720198369
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27402916312
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 4 + 0 + 2 + 9 + 1 + 6 + 3 + 1 + 2 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1720198369 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093832388 DIANA LYNN DILLARD FNP
Individual
Nurse Practitioner (Family)1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1104102540LABORATORY CORPORATION OF AMERICA HOLDINGS
Organization
Clinical Medical Laboratory1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(757) 621-7461
1689792830DR. MOHAMAD A SHAKIR M.D.
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1235694076 JESSICA MARIE HASELMAN FNP
Individual
Nurse Practitioner1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1003010307 JENNIFER LYNN STONE M.D.
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1730138066 CHRISTIAN SORENSEN M.D.
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1174016828 KELLY W HARVEY FNP
Individual
Nurse Practitioner (Family)1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1366402406DR. JOHN JAY MYERS M.D.
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176
1396706214 KENNETH ROBERT MD
Individual
Family Medicine1385 MEDICAL CENTER DR
ROANOKE RAPIDS, NC 27870
(252) 537-9176

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Roanoke Clinic is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.