ST. LOUIS RENAL CARE - PRINCE HALL
NPI 1790845196
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Saint Louis, MO

NPI Status: Active since December 08, 2006

Contact Information

4411 N NEWSTEAD AVE
2ND FLOOR
SAINT LOUIS, MO
ZIP 63115
Phone: (314) 381-7696

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  • Organization
  • Clinic/Center
  • End-Stage Renal Disease (ESRD) Treatment
  • CLIA Number: 26D2092544
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-08-2027

About ST. LOUIS RENAL CARE - PRINCE HALL

This page provides the complete NPI Profile along with additional information for St. Louis Renal Care - Prince Hall, a provider established in Saint Louis, Missouri operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1790845196 assigned on December 2006. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as St. Louis Renal Care - Prince Hall. The authorized official of this NPI record is Mark Fawcett (Treasurer)

NPI
1790845196
Provider Legal Name
SAINT LOUIS RENAL CARE, LLC
Other Organization Name
ST. LOUIS RENAL CARE - PRINCE HALL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
4411 N NEWSTEAD AVE 2ND FLOOR SAINT LOUIS, MO 63115
Location Phone
(314) 381-7696
Mailing Address
4411 N NEWSTEAD AVE 2ND FLOOR SAINT LOUIS, MO 63115
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
12-08-2006
Last Update Date
10-15-2008
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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 End-Stage Renal Disease (ESRD) Treatment

Taxonomy Code
261QE0700X
Type
Ambulatory Health Care Facilities

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARK FAWCETT

Authorized Official Title
TREASURER
Authorized Official Phone
(781) 699-9000

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
262598MEDICARE OSCAR/CERTIFICATION (06)MO 

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
26D2092544
Facility Type
Physician Office
Certificate Effective Date
March 09, 2025
Certificate Expiration Date
March 08, 2027
Laboratory Director
SEROTA HARVEY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to St. Louis Renal Care - Prince Hall 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.

Reviews for ST. LOUIS RENAL CARE - PRINCE HALL

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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 1790845196, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

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.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
4
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
1
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
6
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 9 → 18 → 9 8 → 16 → 7 5 → 10 → 1 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 8 + 0 + 1 + 6 + 4 + 1 + 0 + 1 + 1 + 8 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1790845196.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Social Worker (Clinical)
4411 N NEWSTEAD AVE
SAINT LOUIS, MO 63115
Counselor (Mental Health)
4411 N NEWSTEAD AVE
SAINT LOUIS, MO 63115
Home Health
4411 N NEWSTEAD AVE, SUITE 111
SAINT LOUIS, MO 63115
Community/Behavioral Health
4411 N NEWSTEAD AVE, SUITE 200
SAINT LOUIS, MO 63115
Clinic/Center (Dental)
4411 N NEWSTEAD AVE
ST LOUIS, MO 63115
Psychiatry & Neurology (Psychiatry)
4411 N NEWSTEAD AVE
SAINT LOUIS, MO 63115
Case Management
4411 N NEWSTEAD AVE
SAINT LOUIS, MO 63115
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
4411 N NEWSTEAD AVE, 2ND FLOOR DIALYSIS
SAINT LOUIS, MO 63115

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790845196, enumerated as an "organization" on December 08, 2006.

The provider is located at 4411 N NEWSTEAD AVE 2ND FLOOR SAINT LOUIS, MO 63115 and the phone number is (314) 381-7696.

Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.