MINDFUL RECOVERY ADDICTION SPECIALIST, LLC
NPI 1497252357
Family Medicine - Addiction Medicine in Oneida, TN
NPI Status: Active since April 09, 2018
- Organization
- Family Medicine
- Addiction Medicine
- CLIA Number: 44D2294668
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-28-2025
About MINDFUL RECOVERY ADDICTION SPECIALIST, LLC
This page provides the complete NPI Profile along with additional information for Mindful Recovery Addiction Specialist, Llc, a provider established in Oneida, Tennessee operating as a Family Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1497252357 assigned on April 2018. The practitioner's primary taxonomy code is 207QA0401X. The provider is registered as an organization and their NPI record was last updated 7 years ago. Mindful Recovery Addiction Specialist, Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Paul Caudill (Enrollment Consultant)
- NPI
- 1497252357
- Provider Name
- MINDFUL RECOVERY ADDICTION SPECIALIST, LLC
- Entity Type
- Organization
- Location Address
- 20463 ALBERTA ST ONEIDA, TN 37841
- Location Phone
- (423) 286-3292
- Mailing Address
- 20463 ALBERTA ST ONEIDA, TN 37841
- Mailing Phone
- (423) 286-3292
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-09-2018
- Last Update Date
- 07-03-2018
- 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
Family Medicine Addiction Medicine
- Taxonomy Code
- 207QA0401X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A family medicine physician who specializes in the diagnosis and treatment of addictions.
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 | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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
- 44D2294668
- Facility Type
- Physician Office
- Certificate Effective Date
- November 29, 2023
- Certificate Expiration Date
- November 28, 2025
- Laboratory Director
- CLAY E. STALCUP
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mindful Recovery Addiction Specialist, 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 | 4 | 9 | 7 | 2 | 5 | 2 | 3 | 5 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 18 | 7 | 4 | 5 | 4 | 3 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 8 + 7 + 4 + 5 + 4 + 3 + 1 + 0 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1497252357 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 provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1861647976 | NATE AARON BRENNAN Organization | Podiatrist (Foot & Ankle Surgery) | 20463 ALBERTA ST ONEIDA, TN 37841 (423) 286-7850 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497252357, enumerated in the NPI registry as an "organization" on April 09, 2018
The provider is located at 20463 Alberta St Oneida, Tn 37841 and the phone number is (423) 286-3292
This medical organization specializes in Family Medicine with taxonomy code 207QA0401X with a focus in Addiction Medicine
The provider's CLIA number is 44D2294668 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 April 09, 2018. 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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