BLACK RIVER MEDICAL CENTER
NPI 1992127088
Emergency Medicine in Poplar Bluff, MO
NPI Status: Active since January 09, 2014
Contact Information
217 PHYSICIANS PARK
POPLAR BLUFF, MO
ZIP 63901
Phone: (573) 727-9080
- Organization
- Emergency Medicine
- CLIA Number: 26D2169776
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 07-25-2027
About BLACK RIVER MEDICAL CENTER
This page provides the complete NPI Profile along with additional information for Black River Medical Center, a provider established in Poplar Bluff, Missouri operating as a Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1992127088 assigned on January 2014. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 12 years ago. Black River Medical Center 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 Christy L Shawan (Ceo)
- NPI
- 1992127088
- Provider Name
- BLACK RIVER MEDICAL CENTER
- Entity Type
- Organization
- Location Address
- 217 PHYSICIANS PARK POPLAR BLUFF, MO 63901
- Location Phone
- (573) 727-9080
- Mailing Address
- 217 PHYSICIANS PARK POPLAR BLUFF, MO 63901
- Mailing Phone
- (573) 727-9080
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-09-2014
- Last Update Date
- 01-17-2014
- 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
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
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 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist |
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.
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
- 26D2169776
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- July 26, 2025
- Certificate Expiration Date
- July 25, 2027
- Laboratory Director
- MATTHEW J. RIFFLE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Black River Medical Center 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 1992127088, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
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 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992127088, enumerated as an "organization" on January 09, 2014.
The provider is located at 217 PHYSICIANS PARK POPLAR BLUFF, MO 63901 and the phone number is (573) 727-9080.
Emergency Medicine with taxonomy code 207P00000X.
