VILLISCA MEDICAL CLINIC
NPI 1790758092
Nurse Practitioner - Family in Villisca, IA
NPI Status: Active since February 08, 2006
Contact Information
301 E 4TH ST
VILLISCA, IA
ZIP 50864
Phone: (712) 826-4422
Fax: (712) 826-2052
- Organization
- Nurse Practitioner
- Family
- CLIA Number: 16D1048810
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 12-12-2025
About VILLISCA MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for Villisca Medical Clinic, a provider established in Villisca, Iowa operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1790758092 assigned on February 2006. The practitioner's primary taxonomy code is 363LF0000X with license number 690075H (IA). The provider is registered as an organization and their NPI record was last updated 5 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 provider's is doing business as Villisca Medical Clinic. The authorized official of this NPI record is Ronnel K Badertscher (Business Office Manager)
- NPI
- 1790758092
- Provider Legal Name
- MONTGOMERY COUNTY MEMORIAL HOSPITAL
- Other Organization Name
- VILLISCA MEDICAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 301 E 4TH ST VILLISCA, IA 50864
- Location Phone
- (712) 826-4422
- Location Fax
- (712) 826-2052
- Mailing Address
- 301 E 4TH ST VILLISCA, IA 50864
- Mailing Phone
- (712) 826-4422
- Mailing Fax
- (712) 826-2052
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-08-2006
- Last Update Date
- 08-22-2020
- Code Navigator
A nurse practitioner (NP) like Villisca Medical Clinic is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
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
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 690075H
- License State
- IA
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.
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
- 16D1048810
- Facility Type
- Community Clinic
- Certificate Effective Date
- December 13, 2023
- Certificate Expiration Date
- December 12, 2025
- Laboratory Director
- BRIANNA SCHAFFER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Villisca Medical 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 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 | 7 | 5 | 8 | 0 | 9 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 18 | 0 | 14 | 5 | 16 | 0 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 8 + 0 + 1 + 4 + 5 + 1 + 6 + 0 + 1 + 8 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1790758092 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 2 providers are registered at the same or nearby location.
MS. DENISE W GOSSETT FNP
Clinical Nurse Specialist
(Family Health)
301 E 4TH ST
VILLISCA, IA
ZIP 50864
RICHARD MULLEN IADC
Counselor
(Addiction (Substance Use Disorder))
301 E 4TH ST
VILLISCA, IA
ZIP 50864
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790758092, enumerated as an "organization" on February 08, 2006.
The provider is located at 301 E 4TH ST VILLISCA, IA 50864 and the phone number is (712) 826-4422.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
