FORKS FAMILY MEDICAL CLINIC
NPI 1285290338
Clinic/Center - Rural Health in Forks, WA
NPI Status: Active since May 14, 2019
Contact Information
461 G ST
FORKS, WA
ZIP 98331
Phone: (360) 374-6271
Fax: (360) 374-9781
- Organization
- Clinic/Center
- Rural Health
- Accepts Insurance
- CLIA Number: 50D2170158
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 04-04-2028
About FORKS FAMILY MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for Forks Family Medical Clinic, a primary care provider established in Forks, Washington operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1285290338 assigned on May 2019. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Forks Family Medical Clinic. The authorized official of this NPI record is Carie Micheau (Compliance Officer)
- NPI
- 1285290338
- Provider Legal Name
- CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT NO 1
- Other Organization Name
- FORKS FAMILY MEDICAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 461 G ST FORKS, WA 98331
- Location Phone
- (360) 374-6271
- Location Fax
- (360) 374-9781
- Mailing Address
- 530 BOGACHIEL WAY FORKS, WA 98331
- Mailing Phone
- (360) 374-6271
- Mailing Fax
- (360) 374-9781
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-14-2019
- Last Update Date
- 08-09-2019
- Code Navigator
A primary care provider (PCP) like Forks Family Medical Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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
Clinic/Center Rural Health
- Taxonomy Code
- 261QR1300X
- Type
- Ambulatory Health Care Facilities
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 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 50D2170158
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- August 05, 2019
- Certificate Expiration Date
- April 04, 2028
- Laboratory Director
- FARON J. BAUER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Forks Family Medical 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 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 | 2 | 8 | 5 | 2 | 9 | 0 | 3 | 3 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 16 | 5 | 4 | 9 | 0 | 3 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 6 + 5 + 4 + 9 + 0 + 3 + 6 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1285290338 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1659374114 | DR. STEPHEN H KRIEBEL M.D. Individual | Family Medicine | 461 G ST FORKS, WA 98331 (360) 374-6224 |
| 1770509242 | MS. LAURA ANN KRIPINSKI ARNP Individual | Nurse Practitioner (Family) | 461 G ST FORKS, WA 98331 (360) 374-6224 |
| 1245375518 | FAMILY MEDICAL CENTER OF FORKS, INC, PS Organization | Family Medicine | 461 G ST FORKS, WA 98331 (360) 374-6224 |
| 1255616579 | HARRISON MEDICAL CENTER Organization | Clinic/Center (Rural Health) | 461 G ST FORKS, WA 98331 (360) 374-6224 |
| 1033246673 | WILBERT DANIEL JAMES M.D. Individual | Family Medicine | 461 G ST FORKS, WA 98331 (360) 374-6224 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285290338, enumerated in the NPI registry as an "organization" on May 14, 2019
The provider is located at 461 G St Forks, Wa 98331 and the phone number is (360) 374-6271
This medical organization specializes in Clinic/Center with taxonomy code 261QR1300X with a focus in Rural Health
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 50D2170158 for a "rural health clinic" 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 May 14, 2019. 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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