NORTHRIDGE FAMILY PRACTICE LLC
NPI 1891712493
Nurse Practitioner in Hale, MI
NPI Status: Active since July 17, 2006
Contact Information
3190 NORTHRIDGE DRIVE
HALE, MI
ZIP 48739
Phone: (989) 728-6000
Fax: (989) 728-6003
- Organization
- Nurse Practitioner
About NORTHRIDGE FAMILY PRACTICE LLC
This page provides the complete NPI Profile along with additional information for Northridge Family Practice Llc, a provider established in Hale, Michigan operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1891712493 assigned on July 2006. The practitioner's primary taxonomy code is 363L00000X with license number 4704173663 (MI). The provider is registered as an organization and their NPI record was last updated 11 years ago. Northridge Family Practice Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mrs. Debra Kaye Provoast Rn Msn Fnp (Managing Officer)
- NPI
- 1891712493
- Provider Name
- NORTHRIDGE FAMILY PRACTICE LLC
- Entity Type
- Organization
- Location Address
- 3190 NORTHRIDGE DRIVE HALE, MI 48739
- Location Phone
- (989) 728-6000
- Location Fax
- (989) 728-6003
- Mailing Address
- PO BOX 279 HALE, MI 48739
- Mailing Phone
- (989) 728-6000
- Mailing Fax
- (989) 728-6003
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-17-2006
- Last Update Date
- 11-02-2015
- Code Navigator
A nurse practitioner (NP) like Northridge Family Practice Llc 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
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 4704173663
- License State
- MI
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | 4301061417 (MI) |
| 2 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 4704148660 (MI) |
| 3 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 4704245250 (MI) |
| 4 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 4704283185 (MI) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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.
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.
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 |
|---|---|---|---|
| ========= | OTHER (01) | MI | TAX ID |
| MA061417 | OTHER (01) | MOHAMED ALI | |
| RAILROAD MEDICARE | OTHER (01) | MI | P00261196 |
| 1017859 | OTHER (01) | MI | MCLAREN |
| BW148660 | OTHER (01) | MI | BETH WEAVER LICENSE |
| 105235126 | MEDICAID (05) | MI | |
| 105230710 | MEDICAID (05) | MI | |
| OP24490002 | MEDICARE ID-TYPE UNSPECIFIED (04) | BEATH WEAVER | |
| 104289418 | MEDICAID (05) | MI | |
| OC51020 | OTHER (01) | BLUE CROSS BLUE SHIELD | |
| DD9334 | OTHER (01) | MI | RAILROAD MEDICARE |
| 4704283185 | OTHER (01) | MI | LINDSEY LICENSE |
| 0P24490004 | MEDICARE PIN (08) | MI | |
| =========102 | OTHER (01) | MI | CCM DEBBIE PROVOAST |
| 0P24490 | MEDICARE ID-TYPE UNSPECIFIED (04) | MI | MEDICARE GROUP |
| OP24490001 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| DP173663 | OTHER (01) | MI | DEBBIE PROVOAST LICENSE |
| =========101 | OTHER (01) | MI | CCM BETH WEAVER |
| 1017858 | OTHER (01) | MI | MCLAREN DEB PROVOAST |
| 0P24490001 | MEDICARE PIN (08) | MI |
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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 1891712493, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
HALE, MI 48739
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891712493, enumerated as an "organization" on July 17, 2006.
The provider is located at 3190 NORTHRIDGE DRIVE HALE, MI 48739 and the phone number is (989) 728-6000.
Nurse Practitioner with taxonomy code 363L00000X.
The provider might be accepting Accepts: Medicare, Medicaid, Blue Cross Blue Shield and. Please consult your insurance carrier or call the provider to verify.
