FOND DU LAC REGIONAL CLINIC
NPI 1972879641
Durable Medical Equipment & Medical Supplies in Waupun, WI
NPI Status: Active since March 28, 2012
Contact Information
1001 W MAIN ST
WAUPUN, WI
ZIP 53963
Phone: (920) 324-9301
- Organization
- Durable Medical Equipment & Medical Supp...
- CLIA Number: 52D1053848
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 05-07-2026
About FOND DU LAC REGIONAL CLINIC
This page provides the complete NPI Profile along with additional information for Fond Du Lac Regional Clinic, a provider established in Waupun, Wisconsin operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1972879641 assigned on March 2012. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Fond Du Lac Regional Clinic. The authorized official of this NPI record is Steven N Little (President & Ceo)
- NPI
- 1972879641
- Provider Legal Name
- AGNESIAN HEALTHCARE INC
- Other Organization Name
- FOND DU LAC REGIONAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1001 W MAIN ST WAUPUN, WI 53963
- Location Phone
- (920) 324-9301
- Mailing Address
- 420 E DIVISION ST FOND DU LAC, WI 54935
- Mailing Phone
- (920) 926-8340
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-28-2012
- Last Update Date
- 07-05-2012
- Code Navigator
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
Durable Medical Equipment & Medical Supplies
- Taxonomy Code
- 332B00000X
- Type
- Suppliers
- Taxonomy Description
- A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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.
*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 |
|---|---|---|---|
| 0302620029 | MEDICARE NSC (07) | WI |
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
- 52D1053848
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- May 08, 2024
- Certificate Expiration Date
- May 07, 2026
- Laboratory Director
- SHELLEY MELZER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fond Du Lac Regional 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 1972879641, we treat the final digit (1) 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 79. The final step is to find the difference between that total and the next multiple of ten (80 - 79 = 1).
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 79 is 80. 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.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972879641, enumerated as an "organization" on March 28, 2012.
The provider is located at 1001 W MAIN ST WAUPUN, WI 53963 and the phone number is (920) 324-9301.
Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
