CHARLESTON CLINIC
NPI 1831329887
Nurse Practitioner - Community Health in Charleston, MS

NPI Status: Active since July 23, 2009

Contact Information

401 S CHURCH ST
CHARLESTON, MS
ZIP 38921
Phone: (662) 647-5816

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  • Organization
  • Nurse Practitioner
  • Community Health
  • CLIA Number: 25D0891021
  • CLIA Cert. Type: Other
  • CLIA Exp. Date: 08-29-2026

About CHARLESTON CLINIC

This page provides the complete NPI Profile along with additional information for Charleston Clinic, a provider established in Charleston, Mississippi operating as a Nurse Practitioner, focusing in community health . The healthcare provider is registered in the NPI registry with number 1831329887 assigned on July 2009. The practitioner's primary taxonomy code is 363LC1500X with license number R865030 (MS). The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mrs. Lisa Sudduth Bradham Fnp (Nurse Practitioner)

NPI
1831329887
Provider Name
CHARLESTON CLINIC
Entity Type
Organization
Location Address
401 S CHURCH ST CHARLESTON, MS 38921
Location Phone
(662) 647-5816
Mailing Address
P. O. BOX 21 CHARLESTON, MS 38921
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-23-2009
Last Update Date
07-06-2011
Code Navigator

A nurse practitioner (NP) like Charleston 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.

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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

Nurse Practitioner Community Health

Taxonomy Code
363LC1500X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
R865030
License State
MS

Group Taxonomy 193400000X MULTIPLE 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.

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

MRS. LISA SUDDUTH BRADHAM FNP

Authorized Official Title
NURSE PRACTITIONER
Authorized Official Phone
(662) 647-5816

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
25D0891021
Facility Type
Other
Certificate Effective Date
August 30, 2024
Certificate Expiration Date
August 29, 2026
Laboratory Director
KELLIE D. JONES MLT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Charleston 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 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 1831329887, we treat the final digit (7) 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 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).

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
3
Doubled → 6
Pos 4
1
Unchanged
Pos 5
3
Doubled → 6
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
8
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
7
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 3 → 6 3 → 6 9 → 18 → 9 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 6 + 1 + 6 + 2 + 1 + 8 + 8 + 1 + 6 + 24 = 73

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

The next multiple of ten after 73 is 80. The difference is the calculated check digit.

80 - 73 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1831329887.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
401 S CHURCH ST
CHARLESTON, MS 38921
Dietitian, Registered
401 S CHURCH ST
CHARLESTON, MS 38921
Nurse Practitioner
401 S CHURCH ST
CHARLESTON, MS 38921
Nurse Practitioner
401 S CHURCH ST
CHARLESTON, MS 38921
Family Medicine
401 S CHURCH ST
CHARLESTON, MS 38921
Nurse Practitioner (Family)
401 S CHURCH ST
CHARLESTON, MS 38921

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1831329887, enumerated as an "organization" on July 23, 2009.

The provider is located at 401 S CHURCH ST CHARLESTON, MS 38921 and the phone number is (662) 647-5816.

Nurse Practitioner with taxonomy code 363LC1500X and a focus in Community Health.