AZALEA SKIN TREATMENT CENTER PA
NPI 1760512032
Specialist in Garner, NC
NPI Status: Active since March 06, 2007
Contact Information
958 VANDORA SPRINGS RD
GARNER, NC
ZIP 27529
Phone: (919) 772-3487
Fax: (919) 772-3446
- Organization
- Specialist
- CLIA Number: 34D0724226
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-20-2025
About AZALEA SKIN TREATMENT CENTER PA
This page provides the complete NPI Profile along with additional information for Azalea Skin Treatment Center Pa, a provider established in Garner, North Carolina operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1760512032 assigned on March 2007. The practitioner's primary taxonomy code is 174400000X with license number 29605 (NC). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Mr. William Stewart Ketcham M.d. (President)
- NPI
- 1760512032
- Provider Name
- AZALEA SKIN TREATMENT CENTER PA
- Entity Type
- Organization
- Location Address
- 958 VANDORA SPRINGS RD GARNER, NC 27529
- Location Phone
- (919) 772-3487
- Location Fax
- (919) 772-3446
- Mailing Address
- PO BOX 60634 CHARLOTTE, NC 28260
- Mailing Phone
- (919) 772-3487
- Mailing Fax
- (919) 772-3446
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-06-2007
- Last Update Date
- 04-26-2012
- 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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- 29605
- License State
- NC
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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.
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.
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 |
|---|---|---|---|
| 0273L | OTHER (01) | NC | BCBS OF NC GROUP NUMBER |
| 070014474 | OTHER (01) | NC | RAILROAD MEDICARE |
| 2338206 | MEDICARE PIN (08) | NC |
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
- 34D0724226
- Facility Type
- Physician Office
- Certificate Effective Date
- August 21, 2023
- Certificate Expiration Date
- August 20, 2025
- Laboratory Director
- JONATHAN OLSON
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Azalea Skin Treatment Center Pa after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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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 | 6 | 0 | 5 | 1 | 2 | 0 | 3 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 12 | 0 | 10 | 1 | 4 | 0 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 2 + 0 + 1 + 0 + 1 + 4 + 0 + 6 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1760512032 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
MRS. CRYSTAL RITCHIE THORNTON NP-C
Nurse Practitioner
(Family)
958 VANDORA SPRINGS RD
GARNER, NC
ZIP 27529
MS. CATHY MARIE POOLE FNP
Nurse Practitioner
(Family)
958 VANDORA SPRINGS RD
GARNER, NC
ZIP 27529
ESTHER M.H. NAKAGAWARA O.D.
Optometrist
958 VANDORA SPRINGS RD
GARNER, NC
ZIP 27529
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760512032, enumerated as an "organization" on March 06, 2007.
The provider is located at 958 VANDORA SPRINGS RD GARNER, NC 27529 and the phone number is (919) 772-3487.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare, Medicaid and. Please consult your insurance carrier or call the provider to verify.
