ACTIVATE HEALTHCARE
NPI 1407481997
Clinic/Center in Las Vegas, NV

NPI Status: Active since March 05, 2020

Contact Information

911 N BUFFALO DR UNIT 113
LAS VEGAS, NV
ZIP 89128
Phone: (702) 960-4415

Get Directions Reviews

  • Organization
  • Clinic/Center
  • CLIA Number: 29D2159215
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-12-2026

About ACTIVATE HEALTHCARE

This page provides the complete NPI Profile along with additional information for Activate Healthcare, a provider established in Las Vegas, Nevada operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1407481997 assigned on March 2020. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Activate Healthcare. The authorized official of this NPI record is Jill Johnson Patton (Director Of Risk Management)

NPI
1407481997
Provider Legal Name
EVERSIDE HEALTH, LLC
Other Organization Name
ACTIVATE HEALTHCARE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
911 N BUFFALO DR UNIT 113 LAS VEGAS, NV 89128
Location Phone
(702) 960-4415
Mailing Address
4651 CHARLOTTE PARK DR STE 300 CHARLOTTE, NC 28217
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-05-2020
Last Update Date
08-11-2022
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

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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

JILL JOHNSON PATTON

Authorized Official Title
DIRECTOR OF RISK MANAGEMENT
Authorized Official Phone
(704) 936-5546

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
29D2159215
Facility Type
Physician Office
Certificate Effective Date
December 13, 2024
Certificate Expiration Date
December 12, 2026
Laboratory Director
KATHLEEN T. WAGNER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Activate Healthcare 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.

Reviews for ACTIVATE HEALTHCARE

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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.
1407481997
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2407882918
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 0 + 7 + 8 + 8 + 2 + 9 + 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 1407481997 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023346707ANGELA L. LORENZO, PA-C, LTD.
Organization
Clinic/Center (Primary Care)911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(702) 987-1555
1104490135EVERSIDE HEALTH, LLC
Organization
Clinic/Center (Health Service)911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(702) 960-4441
1588148092EVERSIDE HEALTH, LLC
Organization
Clinic/Center (Health Service)911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(773) 697-3144
1891279329EVERSIDE HEALTH, LLC
Organization
Clinic/Center (Health Service)911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(773) 697-3144
1972137768EVERSIDE HEALTH, LLC
Organization
Clinic/Center911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(702) 960-4415
1386764116 HEATHER TAMBURRINO PA-C
Individual
Physician Assistant911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(702) 960-4441
1215681127 KATHERINE GAMBILL FNP-C
Individual
Nurse Practitioner (Family)911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(702) 960-4441
1013581248 REBECCA SEQUEIRA WILKINS FNP
Individual
Nurse Practitioner911 N BUFFALO DR UNIT 113
LAS VEGAS, NV 89128
(702) 960-4441

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407481997, enumerated in the NPI registry as an "organization" on March 05, 2020

The provider is located at 911 N Buffalo Dr Unit 113 Las Vegas, Nv 89128 and the phone number is (702) 960-4415

This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X

The provider's CLIA number is 29D2159215 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 March 05, 2020. 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.