CONNELLY HEALTH CLINIC
NPI 1427131432
Clinic/Center - Military/U.S. Coast Guard Outpatient in Fort Gordon, GA
NPI Status: Active since October 23, 2006
Contact Information
29709 B STREET
FORT GORDON, GA
ZIP 30905
Phone: (706) 787-5811
- Organization
- Clinic/Center
- Military/U.S. Coast Guard Outpatient
About CONNELLY HEALTH CLINIC
This page provides the complete NPI Profile along with additional information for Connelly Health Clinic, a provider established in Fort Gordon, Georgia operating as a Clinic/center, focusing in military/u.s. coast guard outpatient . The healthcare provider is registered in the NPI registry with number 1427131432 assigned on October 2006. The practitioner's primary taxonomy code is 261QM1100X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Connelly Health Clinic. The authorized official of this NPI record is Marvin Primos (Ubo Manager)
- NPI
- 1427131432
- Provider Legal Name
- EISENHOWER ARMY MEDICAL CENTER
- Other Organization Name
- CONNELLY HEALTH CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 29709 B STREET FORT GORDON, GA 30905
- Location Phone
- (706) 787-5811
- Mailing Address
- 300 W HOSPITAL RD BLDG W ATTN MCHF-PAD FORT GORDON, GA 30905
- Mailing Phone
- (706) 787-1125
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 10-23-2006
- Last Update Date
- 01-31-2013
- 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 Military/U.S. Coast Guard Outpatient
- Taxonomy Code
- 261QM1100X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
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 | 332000000X | Suppliers | Military/U.S. Coast Guard Pharmacy |
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 |
|---|---|---|---|
| VAD000 | MEDICARE UPIN (02) | ||
| OTH000 | MEDICARE UPIN (02) | ||
| 1578660742 | OTHER (01) | PARENT MTF NPI |
Reviews for CONNELLY HEALTH CLINIC
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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 | 2 | 7 | 1 | 3 | 1 | 4 | 3 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 2 | 3 | 2 | 4 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 2 + 3 + 2 + 4 + 6 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1427131432 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1790951697 | BARBARA ELLEN FIGUEROA LPN Individual | Licensed Practical Nurse | 29709 B STREET CONNELLY HEALTH CLINIC FORT GORDON, GA 30905 (706) 787-5174 |
| 1588180913 | JON FRENCH PA-C Individual | Physician Assistant | 29709 B STREET AUGUSTA, GA 30905 (706) 787-5143 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427131432, enumerated in the NPI registry as an "organization" on October 23, 2006
The provider is located at 29709 B Street Fort Gordon, Ga 30905 and the phone number is (706) 787-5811
This medical organization specializes in Clinic/Center with taxonomy code 261QM1100X with a focus in Military/U.S. Coast Guard Outpatient
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.
This NPI record was last updated on October 23, 2006. 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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