GRITMAN INTERNAL MEDICINE CLINIC
NPI 1790182590
Clinic/Center in Moscow, ID
NPI Status: Active since November 24, 2014
Contact Information
804 S WASHINGTON ST STE A
MOSCOW, ID
ZIP 83843
Phone: (208) 883-1152
Fax: (208) 882-1486
- Organization
- Clinic/Center
- CLIA Number: 13D2285747
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-17-2025
About GRITMAN INTERNAL MEDICINE CLINIC
This page provides the complete NPI Profile along with additional information for Gritman Internal Medicine Clinic, a provider established in Moscow, Idaho operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1790182590 assigned on November 2014. The practitioner's primary taxonomy code is 261Q00000X with license number 39 (ID). The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Gritman Internal Medicine Clinic. The authorized official of this NPI record is Preston J Becker (Cfo)
- NPI
- 1790182590
- Provider Legal Name
- GRITMAN MEDICAL CENTER INC.
- Other Organization Name
- GRITMAN INTERNAL MEDICINE CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 804 S WASHINGTON ST STE A MOSCOW, ID 83843
- Location Phone
- (208) 883-1152
- Location Fax
- (208) 882-1486
- Mailing Address
- 700 S MAIN ST MOSCOW, ID 83843
- Mailing Phone
- (208) 882-4511
- Mailing Fax
- (208) 882-1486
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 11-24-2014
- Last Update Date
- 12-04-2015
- 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
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 39
- License State
- ID
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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 |
|---|---|---|---|
| 1253203 | MEDICARE PIN (08) | ID |
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
- 13D2285747
- Facility Type
- Physician Office
- Certificate Effective Date
- July 18, 2023
- Certificate Expiration Date
- July 17, 2025
- Laboratory Director
- RAJEEV RAJENDRA
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Gritman Internal Medicine Clinic 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.
Reviews for GRITMAN INTERNAL MEDICINE CLINIC
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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 | 9 | 0 | 1 | 8 | 2 | 5 | 9 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 18 | 0 | 2 | 8 | 4 | 5 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 8 + 0 + 2 + 8 + 4 + 5 + 1 + 8 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1790182590 is valid because the calculated check digit 0 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.
GRITMAN MEDICAL CENTER INC
Internal Medicine
804 S WASHINGTON ST STE A
MOSCOW, ID
ZIP 83843
GRITMAN MEDICAL CENTER INC
Pain Medicine
(Interventional Pain Medicine)
804 S WASHINGTON ST STE A
MOSCOW, ID
ZIP 83843
DUSTIN PAUL GILL
Nurse Anesthetist, Certified Registered
804 S WASHINGTON ST STE A
MOSCOW, ID
ZIP 83843
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790182590, enumerated as an "organization" on November 24, 2014.
The provider is located at 804 S WASHINGTON ST STE A MOSCOW, ID 83843 and the phone number is (208) 883-1152.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
