ELMS AT TANGLEWOOD
NPI 1962648543
Assisted Living Facility in Clemmons, NC

NPI Status: Active since January 02, 2009

Contact Information

3750 HARPER RD
CLEMMONS, NC
ZIP 27012
Phone: (336) 766-2131
Fax: (336) 766-2160

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 34D2017454
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 12-12-2026

About ELMS AT TANGLEWOOD

This page provides the complete NPI Profile along with additional information for Elms At Tanglewood, a provider established in Clemmons, North Carolina operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1962648543 assigned on January 2009. The practitioner's primary taxonomy code is 310400000X with license number HAL034085 (NC). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Elms At Tanglewood. The authorized official of this NPI record is Mrs. Deborah Ann Mathis (Coo)

NPI
1962648543
Provider Legal Name
LSA ELMS AT TANGLEWOOD, INC.
Other Organization Name
ELMS AT TANGLEWOOD
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3750 HARPER RD CLEMMONS, NC 27012
Location Phone
(336) 766-2131
Location Fax
(336) 766-2160
Mailing Address
3750 HARPER RD CLEMMONS, NC 27012
Mailing Phone
(336) 766-2131
Mailing Fax
(336) 766-2160
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-02-2009
Last Update Date
01-02-2009
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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
License No.
HAL034085
License State
NC
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.

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)
1311500000XNursing & Custodial Care Facilities

Alzheimer Center (Dementia Center)

HAL034085 (NC)

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. DEBORAH ANN MATHIS

Authorized Official Title
COO
Authorized Official Phone
(704) 637-2870

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
34D2017454
Facility Type
Assisted Living Facility
Certificate Effective Date
December 13, 2024
Certificate Expiration Date
December 12, 2026
Laboratory Director
FRANDEE NICHOLS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Elms At Tanglewood 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 1962648543, 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.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
2
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
4
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
5
Unchanged
Pos 9
4
Doubled → 8
Check
3
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 6 → 12 → 3 6 → 12 → 3 8 → 16 → 7 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 1 + 2 + 2 + 1 + 2 + 4 + 1 + 6 + 5 + 8 + 24 = 67

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.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1962648543.

Other Providers at the Same Location


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

Assisted Living Facility
3750 HARPER RD
CLEMMONS, NC 27012

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962648543, enumerated as an "organization" on January 02, 2009.

The provider is located at 3750 HARPER RD CLEMMONS, NC 27012 and the phone number is (336) 766-2131.

Assisted Living Facility with taxonomy code 310400000X.