LARSON HOUSE PLATINUM LLC
NPI 1811517642
Assisted Living Facility in Columbus, WI

NPI Status: Active since April 22, 2020

Contact Information

550 RIVER RD
COLUMBUS, WI
ZIP 53925
Phone: (920) 623-5253
Fax: (920) 623-5255

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 52D1016891
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 01-20-2027

About LARSON HOUSE PLATINUM LLC

This page provides the complete NPI Profile along with additional information for Larson House Platinum Llc, a provider established in Columbus, Wisconsin operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1811517642 assigned on April 2020. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is John Teresinski (Managing Director)

NPI
1811517642
Provider Name
LARSON HOUSE PLATINUM LLC
Entity Type
Organization
Location Address
550 RIVER RD COLUMBUS, WI 53925
Location Phone
(920) 623-5253
Location Fax
(920) 623-5255
Mailing Address
2448 S 102ND ST STE 305 WEST ALLIS, WI 53227
Mailing Phone
(414) 940-6608
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-22-2020
Last Update Date
04-22-2020
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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

JOHN TERESINSKI

Authorized Official Title
MANAGING DIRECTOR
Authorized Official Phone
(414) 940-6608

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
0015679OTHER (01)WIWISCONSIN DHS
0016818OTHER (01)WIWISCNSIN DHS

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
52D1016891
Facility Type
Assisted Living Facility
Certificate Effective Date
January 21, 2025
Certificate Expiration Date
January 20, 2027
Laboratory Director
MS. MELISSA BLOOMHUFF
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Larson House Platinum Llc 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 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 1811517642, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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
8
Unchanged
Pos 3
1
Doubled → 2
Pos 4
1
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
6
Unchanged
Pos 9
4
Doubled → 8
Check
2
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 1 → 2 5 → 10 → 1 7 → 14 → 5 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 2 + 1 + 1 + 0 + 1 + 1 + 4 + 6 + 8 + 24 = 58

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

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1811517642.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Assisted Living Facility
550 RIVER RD
COLUMBUS, WI 53925

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811517642, enumerated as an "organization" on April 22, 2020.

The provider is located at 550 RIVER RD COLUMBUS, WI 53925 and the phone number is (920) 623-5253.

Assisted Living Facility with taxonomy code 310400000X.

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