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
- 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).
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.
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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 | 4 | 0 | 7 | 4 | 8 | 1 | 9 | 9 | 7 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 4 | 0 | 7 | 8 | 8 | 2 | 9 | 18 | |
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 = 7 | 7 |
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 |
---|---|---|---|
1023346707 | ANGELA L. LORENZO, PA-C, LTD. Organization | Clinic/Center (Primary Care) | 911 N BUFFALO DR UNIT 113 LAS VEGAS, NV 89128 (702) 987-1555 |
1104490135 | EVERSIDE HEALTH, LLC Organization | Clinic/Center (Health Service) | 911 N BUFFALO DR UNIT 113 LAS VEGAS, NV 89128 (702) 960-4441 |
1588148092 | EVERSIDE HEALTH, LLC Organization | Clinic/Center (Health Service) | 911 N BUFFALO DR UNIT 113 LAS VEGAS, NV 89128 (773) 697-3144 |
1891279329 | EVERSIDE HEALTH, LLC Organization | Clinic/Center (Health Service) | 911 N BUFFALO DR UNIT 113 LAS VEGAS, NV 89128 (773) 697-3144 |
1972137768 | EVERSIDE HEALTH, LLC Organization | Clinic/Center | 911 N BUFFALO DR UNIT 113 LAS VEGAS, NV 89128 (702) 960-4415 |
1386764116 | HEATHER TAMBURRINO PA-C Individual | Physician Assistant | 911 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 Practitioner | 911 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].
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