BLUE WATER THERAPY, LLC
NPI 1245475797
Clinic/Center - Rehabilitation in Fargo, ND

NPI Status: Active since December 12, 2008

Contact Information

3321 4TH AVE S STE D
FARGO, ND
ZIP 58103
Phone: (701) 200-8181

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  • Organization
  • Clinic/Center
  • Rehabilitation

About BLUE WATER THERAPY, LLC

This page provides the complete NPI Profile along with additional information for Blue Water Therapy, Llc, a provider established in Fargo, North Dakota operating as a Clinic/center, focusing in rehabilitation . The healthcare provider is registered in the NPI registry with number 1245475797 assigned on December 2008. The practitioner's primary taxonomy code is 261QR0400X with license number 995 (ND). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Gabriel Thomas Evenson Motr/l (President)

NPI
1245475797
Provider Name
BLUE WATER THERAPY, LLC
Entity Type
Organization
Location Address
3321 4TH AVE S STE D FARGO, ND 58103
Location Phone
(701) 200-8181
Mailing Address
4425 47TH ST S FARGO, ND 58104
Mailing Phone
(701) 200-8181
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-12-2008
Last Update Date
12-12-2008
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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

Clinic/Center Rehabilitation

Taxonomy Code
261QR0400X
Type
Ambulatory Health Care Facilities
License No.
995
License State
ND

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

GABRIEL THOMAS EVENSON MOTR/L

Authorized Official Title
PRESIDENT
Authorized Official Phone
(701) 200-8181

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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.
1245475797
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22858710718
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 8 + 5 + 8 + 7 + 1 + 0 + 7 + 1 + 8 + 24 = 73
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 73 = 77

The NPI number 1245475797 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245475797, enumerated in the NPI registry as an "organization" on December 12, 2008

The provider is located at 3321 4th Ave S Ste D Fargo, Nd 58103 and the phone number is (701) 200-8181

This medical organization specializes in Clinic/Center with taxonomy code 261QR0400X with a focus in Rehabilitation

This NPI record was last updated on December 12, 2008. 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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