BEAVER MEDICAL GROUP - BANNING EXTENDED CARE
NPI 1881857597
Non-Pharmacy Dispensing Site in Banning, CA

NPI Status: Active since July 03, 2008

Contact Information

6109 W RAMSEY ST
BANNING, CA
ZIP 92220
Phone: (951) 845-0313

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  • Organization
  • Non-Pharmacy Dispensing Site
  • CLIA Number: 05D1065044
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 02-19-2027

About BEAVER MEDICAL GROUP - BANNING EXTENDED CARE

This page provides the complete NPI Profile along with additional information for Beaver Medical Group - Banning Extended Care, a provider established in Banning, California operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1881857597 assigned on July 2008. The practitioner's primary taxonomy code is 332900000X with license number C51632 (CA). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Beaver Medical Group - Banning Extended Care. The authorized official of this NPI record is Kenny Heine (Vp Of Operations)

NPI
1881857597
Provider Legal Name
BEAVER MEDICAL GROUP LP
Other Organization Name
BEAVER MEDICAL GROUP - BANNING EXTENDED CARE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
6109 W RAMSEY ST BANNING, CA 92220
Location Phone
(951) 845-0313
Mailing Address
5626 OBERLIN DR SUITE 110 SAN DIEGO, CA 92121
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
07-03-2008
Last Update Date
04-25-2013
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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

Non-Pharmacy Dispensing Site

Taxonomy Code
332900000X
Type
Suppliers
License No.
C51632
License State
CA
Taxonomy Description
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

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

KENNY HEINE

Authorized Official Title
VP OF OPERATIONS
Authorized Official Phone
(858) 625-2990

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
05D1065044
Facility Type
Community Clinic
Certificate Effective Date
February 20, 2025
Certificate Expiration Date
February 19, 2027
Laboratory Director
DR. JILL R. CUNI
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Beaver Medical Group - Banning Extended Care in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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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 1881857597, 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
8
Doubled → 16 → 1 + 6
Pos 4
1
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
5
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
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 8 → 16 → 7 8 → 16 → 7 7 → 14 → 5 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 1 + 6 + 1 + 1 + 6 + 5 + 1 + 4 + 5 + 1 + 8 + 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 1881857597.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Pulmonary Disease)
6109 W RAMSEY ST
BANNING, CA 92220
Internal Medicine (Cardiovascular Disease)
6109 W RAMSEY ST
BANNING, CA 92220
Family Medicine
6109 W RAMSEY ST
BANNING, CA 92220
Physician Assistant
6109 W RAMSEY ST
BANNING, CA 92220
Clinical Medical Laboratory
6109 W RAMSEY ST
BANNING, CA 92220
Physician Assistant
6109 W RAMSEY ST
BANNING, CA 92220
Internal Medicine (Pulmonary Disease)
6109 W RAMSEY ST
BANNING, CA 92220
Optometrist
6109 W RAMSEY ST
BANNING, CA 92220
Internal Medicine (Cardiovascular Disease)
6109 W RAMSEY ST
BANNING, CA 92220
Internal Medicine (Gastroenterology)
6109 W RAMSEY ST
BANNING, CA 92220
Internal Medicine (Pulmonary Disease)
6109 W RAMSEY ST
BANNING, CA 92220
Nurse Practitioner (Family)
6109 W RAMSEY ST
BANNING, CA 92220
Hospitalist
6109 W RAMSEY ST
BANNING, CA 92220
Nurse Practitioner
6109 W RAMSEY ST
BANNING, CA 92220
Internal Medicine
6109 W RAMSEY ST
BANNING, CA 92220
Family Medicine
6109 W RAMSEY ST
BANNING, CA 92220
Family Medicine
6109 W RAMSEY ST
BANNING, CA 92220
Nurse Practitioner (Family)
6109 W RAMSEY ST
BANNING, CA 92220
Hospitalist
6109 W RAMSEY ST
BANNING, CA 92220
Pediatrics
6109 W RAMSEY ST
BANNING, CA 92220

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1881857597, enumerated as an "organization" on July 03, 2008.

The provider is located at 6109 W RAMSEY ST BANNING, CA 92220 and the phone number is (951) 845-0313.

Non-Pharmacy Dispensing Site with taxonomy code 332900000X.