HEALTHY LIFESTYLE MEDICINE
NPI 1912478819
Family Medicine - Adult Medicine in Cheyenne, WY

NPI Status: Active since December 17, 2018

Contact Information

6015 SYCAMORE RD
CHEYENNE, WY
ZIP 82009
Phone: (307) 823-2968

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  • Organization
  • Family Medicine
  • Adult Medicine
  • CLIA Number: 53D2161117
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-27-2027

About HEALTHY LIFESTYLE MEDICINE

This page provides the complete NPI Profile along with additional information for Healthy Lifestyle Medicine, a primary care provider established in Cheyenne, Wyoming operating as a Family Medicine, focusing in adult medicine . The healthcare provider is registered in the NPI registry with number 1912478819 assigned on December 2018. The practitioner's primary taxonomy code is 207QA0505X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Healthy Lifestyle Medicine 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 Kristine Van Kirk Md (Owner/provider)

NPI
1912478819
Provider Name
HEALTHY LIFESTYLE MEDICINE
Entity Type
Organization
Location Address
6015 SYCAMORE RD CHEYENNE, WY 82009
Location Phone
(307) 823-2968
Mailing Address
6015 SYCAMORE RD CHEYENNE, WY 82009
Mailing Phone
(307) 823-2968
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-17-2018
Last Update Date
12-20-2018
Code Navigator

A primary care provider (PCP) like Healthy Lifestyle Medicine sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Family Medicine Adult Medicine

Taxonomy Code
207QA0505X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

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)
12083B0002XAllopathic & Osteopathic Physicians

Preventive Medicine
Obesity Medicine

 

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.

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

KRISTINE VAN KIRK MD

Authorized Official Title
OWNER/PROVIDER
Authorized Official Phone
(307) 823-2968

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
53D2161117
Facility Type
Physician Office
Certificate Effective Date
January 28, 2025
Certificate Expiration Date
January 27, 2027
Laboratory Director
KRISTINE VANKIRK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Healthy Lifestyle Medicine 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 1912478819, we treat the final digit (9) 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 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).

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

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 2 + 2 + 8 + 7 + 1 + 6 + 8 + 2 + 24 = 71

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

The next multiple of ten after 71 is 80. The difference is the calculated check digit.

80 - 71 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1912478819.

Other Providers at the Same Location


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

Dentist (General Practice)
6015 SYCAMORE RD
CHEYENNE, WY 82009
Family Medicine
6015 SYCAMORE RD, 1ST FLOOR
CHEYENNE, WY 82009
Clinic/Center (Primary Care)
6015 SYCAMORE RD, 1ST FLOOR
CHEYENNE, WY 82009
Family Medicine (Adult Medicine)
6015 SYCAMORE RD
CHEYENNE, WY 82009
Dentist (General Practice)
6015 SYCAMORE RD
CHEYENNE, WY 82009
Dentist (General Practice)
6015 SYCAMORE RD
CHEYENNE, WY 82009

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1912478819, enumerated as an "organization" on December 17, 2018.

The provider is located at 6015 SYCAMORE RD CHEYENNE, WY 82009 and the phone number is (307) 823-2968.

Family Medicine with taxonomy code 207QA0505X and a focus in Adult Medicine.