EMERGACARE
NPI 1356556518
Clinic/Center - Urgent Care in Jackson, WY
NPI Status: Active since May 11, 2007
Contact Information
982 W BROADWAY
JACKSON, WY
ZIP 83001
Phone: (307) 733-8002
Fax: (307) 733-0032
- Organization
- Clinic/Center
- Urgent Care
- CLIA Number: 53D0666667
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-30-2026
About EMERGACARE
This page provides the complete NPI Profile along with additional information for Emergacare, a provider established in Jackson, Wyoming operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1356556518 assigned on May 2007. The practitioner's primary taxonomy code is 261QU0200X with license number 3416A (WY). The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as Emergacare. The authorized official of this NPI record is Brent Blue Md (Owner)
- NPI
- 1356556518
- Provider Legal Name
- BRENT BLUE MD
- Other Organization Name
- EMERGACARE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 982 W BROADWAY JACKSON, WY 83001
- Location Phone
- (307) 733-8002
- Location Fax
- (307) 733-0032
- Mailing Address
- PO BOX 15240 JACKSON, WY 83002
- Mailing Phone
- (307) 733-8002
- Mailing Fax
- (307) 733-0032
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-11-2007
- Last Update Date
- 06-28-2010
- 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
Clinic/Center Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
- License No.
- 3416A
- License State
- WY
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 |
|---|---|---|---|
| 4371429 | MEDICARE ID-TYPE UNSPECIFIED (04) | WY | RAILROAD MCARE GR NUMBER |
| 109651600 | MEDICAID (05) | WY | |
| 218545001 | OTHER (01) | WY | USDOL CLINIC NUMBER |
| W305961 | MEDICARE PIN (08) |
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
- 53D0666667
- Facility Type
- Physician Office
- Certificate Effective Date
- May 31, 2024
- Certificate Expiration Date
- May 30, 2026
- Laboratory Director
- KEVIN C. SANVILLE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Emergacare 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 | 3 | 5 | 6 | 5 | 5 | 6 | 5 | 1 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 10 | 6 | 10 | 5 | 12 | 5 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 0 + 6 + 1 + 0 + 5 + 1 + 2 + 5 + 2 + 24 = 52 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 52 = 8 | 8 | ||||||||
The NPI number 1356556518 is valid because the calculated check digit 8 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 1356556518, enumerated in the NPI registry as an "organization" on May 11, 2007
The provider is located at 982 W Broadway Jackson, Wy 83001 and the phone number is (307) 733-8002
This medical organization specializes in Clinic/Center with taxonomy code 261QU0200X with a focus in Urgent Care
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 53D0666667 for a "physician office" 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 11, 2007. 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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