PEARL MEDICAL PRACTICE PLLC
NPI 1720894140
Community/Behavioral Health in Louisville, KY
NPI Status: Active since December 10, 2024
Contact Information
2615 DIXIE HWY
LOUISVILLE, KY
ZIP 40216
Phone: (502) 338-2964
- Organization
- Community/Behavioral Health
- CLIA Number: 18D2085247
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-10-2027
About PEARL MEDICAL PRACTICE PLLC
This page provides the complete NPI Profile along with additional information for Pearl Medical Practice Pllc, a provider established in Louisville, Kentucky operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1720894140 assigned on December 2024. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Dr. Osawaru Omoruyi Md (Ceo)
- NPI
- 1720894140
- Provider Name
- PEARL MEDICAL PRACTICE PLLC
- Entity Type
- Organization
- Location Address
- 2615 DIXIE HWY LOUISVILLE, KY 40216
- Location Phone
- (502) 338-2964
- Mailing Address
- 2202 BUECHEL AVE LOUISVILLE, KY 40218
- Mailing Phone
- (502) 456-0494
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 12-10-2024
- Last Update Date
- 12-10-2024
- 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/Behavioral Health
- Taxonomy Code
- 251S00000X
- Type
- Agencies
- Taxonomy Description
- A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
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
- 18D2085247
- Facility Type
- Physician Office
- Certificate Effective Date
- December 11, 2025
- Certificate Expiration Date
- December 10, 2027
- Laboratory Director
- DR. LEWIS JACKSON
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Pearl Medical Practice Pllc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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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 1720894140, we treat the final digit (0) 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 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).
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 70 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720894140, enumerated as an "organization" on December 10, 2024.
The provider is located at 2615 DIXIE HWY LOUISVILLE, KY 40216 and the phone number is (502) 338-2964.
Community/Behavioral Health with taxonomy code 251S00000X.
