WHITEVILLE MEDICAL CLINIC, LLC
NPI 1073754636
Nurse Practitioner - Family in Whiteville, TN
NPI Status: Active since March 11, 2009
Contact Information
2060 US HIGHWAY 64
SUITE C
WHITEVILLE, TN
ZIP 38075
Phone: (901) 626-6626
- Organization
- Nurse Practitioner
- Family
- CLIA Number: 44D0949980
- CLIA Cert. Type: Prison
- CLIA Exp. Date: 08-16-2026
About WHITEVILLE MEDICAL CLINIC, LLC
This page provides the complete NPI Profile along with additional information for Whiteville Medical Clinic, Llc, a provider established in Whiteville, Tennessee operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1073754636 assigned on March 2009. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. Whiteville Medical Clinic, Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dee Blakney (Dnp)
- NPI
- 1073754636
- Provider Name
- WHITEVILLE MEDICAL CLINIC, LLC
- Entity Type
- Organization
- Location Address
- 2060 US HIGHWAY 64 SUITE C WHITEVILLE, TN 38075
- Location Phone
- (901) 626-6626
- Mailing Address
- 2060 US HIGHWAY 64 SUITE C WHITEVILLE, TN 38075
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-11-2009
- Last Update Date
- 03-11-2009
- Code Navigator
A nurse practitioner (NP) like Whiteville Medical Clinic, 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 Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
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 | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
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
- 44D0949980
- Facility Type
- Prison
- Certificate Effective Date
- August 17, 2024
- Certificate Expiration Date
- August 16, 2026
- Laboratory Director
- DR. BERNARD E. DIETZ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Whiteville Medical Clinic, Llc 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 Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 7 | 3 | 7 | 5 | 4 | 6 | 3 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 14 | 3 | 14 | 5 | 8 | 6 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 4 + 3 + 1 + 4 + 5 + 8 + 6 + 6 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1073754636 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1821320466 | WHITEVILLE FAMILY MEDICAL CLINIC, LLC Organization | Nurse Practitioner (Family) | 2060 US HIGHWAY 64 SUITE C WHITEVILLE, TN 38075 (731) 254-8999 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073754636, enumerated in the NPI registry as an "organization" on March 11, 2009
The provider is located at 2060 Us Highway 64 Suite C Whiteville, Tn 38075 and the phone number is (901) 626-6626
This medical organization specializes in Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family
The provider's CLIA number is 44D0949980 for a "prison" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on March 11, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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