COUNTRYSIDE MEDICAL CLINIC, LLC
NPI 1396103685
Clinic/Center - Primary Care in Red Oak, IA
NPI Status: Active since February 02, 2016
Contact Information
1959 200TH ST
RED OAK, IA
ZIP 51566
Phone: (712) 629-0040
Fax: (712) 566-5049
- Organization
- Clinic/Center
- Primary Care
- Accepts Insurance
- CLIA Number: 16D2135938
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 08-28-2025
About COUNTRYSIDE MEDICAL CLINIC, LLC
This page provides the complete NPI Profile along with additional information for Countryside Medical Clinic, Llc, a primary care provider established in Red Oak, Iowa operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1396103685 assigned on February 2016. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Ms. Kimberly Lynn Rines Arnp (Nurse Practitioner)
- NPI
- 1396103685
- Provider Name
- COUNTRYSIDE MEDICAL CLINIC, LLC
- Entity Type
- Organization
- Location Address
- 1959 200TH ST RED OAK, IA 51566
- Location Phone
- (712) 629-0040
- Location Fax
- (712) 566-5049
- Mailing Address
- 1959 200TH ST RED OAK, IA 51566
- Mailing Phone
- (712) 629-0040
- Mailing Fax
- (712) 566-5049
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-02-2016
- Last Update Date
- 12-12-2018
- Code Navigator
A primary care provider (PCP) like Countryside Medical Clinic, Llc 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 Primary Care
- Taxonomy Code
- 261QP2300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
- Medica Insure Bronze Premier - EPO
- Medica Insure Bronze Share - EPO
- Medica Insure Expanded Bronze Standard - EPO
- Medica Insure Gold $0 Copay PCP Visits - EPO
- Medica Insure Gold Share - EPO
- Medica Insure Gold Standard - EPO
- Medica Insure Silver $0 Copay PCP Visits - EPO
- Medica Insure Silver Share - EPO
- Medica Insure Silver Standard - EPO
*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
- 16D2135938
- Facility Type
- Practitioner Other
- Certificate Effective Date
- August 29, 2023
- Certificate Expiration Date
- August 28, 2025
- Laboratory Director
- KIMBERLY L. RINES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Countryside 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 | 3 | 9 | 6 | 1 | 0 | 3 | 6 | 8 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 2 | 0 | 6 | 6 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 2 + 0 + 6 + 6 + 1 + 6 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1396103685 is valid because the calculated check digit 5 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 1396103685, enumerated in the NPI registry as an "organization" on February 02, 2016
The provider is located at 1959 200th St Red Oak, Ia 51566 and the phone number is (712) 629-0040
This medical organization specializes in Clinic/Center with taxonomy code 261QP2300X with a focus in Primary Care
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 16D2135938 for a "practitioner other" 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 February 02, 2016. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.