MOUNT VERNON HEALTHY LIVING CENTER
NPI 1427366921
Clinic/Center - Primary Care in Mount Vernon, IL
NPI Status: Active since September 17, 2010
Contact Information
5100 LAKE TERRANCE NE
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 899-5001
- Organization
- Clinic/Center
- Primary Care
- CLIA Number: 14D2014391
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-06-2026
About MOUNT VERNON HEALTHY LIVING CENTER
This page provides the complete NPI Profile along with additional information for Mount Vernon Healthy Living Center, a primary care provider established in Mount Vernon, Illinois operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1427366921 assigned on September 2010. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Mount Vernon Healthy Living Center. The authorized official of this NPI record is Dr. Jon Leizman Md (President)
- NPI
- 1427366921
- Provider Legal Name
- PREMISE HEALTH OF ILLINOIS MEDICAL, PC
- Other Organization Name
- MOUNT VERNON HEALTHY LIVING CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 5100 LAKE TERRANCE NE MOUNT VERNON, IL 62864
- Location Phone
- (618) 899-5001
- Mailing Address
- 5500 MARYLAND WAY STE 120 BRENTWOOD, TN 37027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-17-2010
- Last Update Date
- 08-17-2023
- Code Navigator
A primary care provider (PCP) like Mount Vernon Healthy Living Center 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
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 | 261QX0100X | Ambulatory Health Care Facilities | Clinic/Center |
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
- 14D2014391
- Facility Type
- Physician Office
- Certificate Effective Date
- October 07, 2024
- Certificate Expiration Date
- October 06, 2026
- Laboratory Director
- AMANDA ENGELE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mount Vernon Healthy Living Center 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 MOUNT VERNON HEALTHY LIVING CENTER
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. | |||||||||
| 1 | 4 | 2 | 7 | 3 | 6 | 6 | 9 | 2 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 6 | 6 | 12 | 9 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 6 + 6 + 1 + 2 + 9 + 4 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1427366921 is valid because the calculated check digit 1 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 1427366921, enumerated in the NPI registry as an "organization" on September 17, 2010
The provider is located at 5100 Lake Terrance Ne Mount Vernon, Il 62864 and the phone number is (618) 899-5001
This medical organization specializes in Clinic/Center with taxonomy code 261QP2300X with a focus in Primary Care
The provider's CLIA number is 14D2014391 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 September 17, 2010. 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.