FRUITVALE HEALTH CARE CENTER
NPI 1508295478
Skilled Nursing Facility in Oakland, CA
NPI Status: Active since November 01, 2013
- Organization
- Skilled Nursing Facility
- CLIA Number: 05D0883158
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 02-25-2026
About FRUITVALE HEALTH CARE CENTER
This page provides the complete NPI Profile along with additional information for Fruitvale Health Care Center, a provider established in Oakland, California operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1508295478 assigned on November 2013. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Fruitvale Health Care Center. The authorized official of this NPI record is Kam Mcgavock (President)
- NPI
- 1508295478
- Provider Legal Name
- FRUITVALE LONG TERM CARE LLC
- Other Organization Name
- FRUITVALE HEALTH CARE CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3020 E 15TH ST OAKLAND, CA 94601
- Location Phone
- (510) 261-5613
- Mailing Address
- 920 RIDGEBROOK RD SPARKS, MD 21152
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-01-2013
- Last Update Date
- 11-01-2013
- 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
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
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
- 05D0883158
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- February 26, 2024
- Certificate Expiration Date
- February 25, 2026
- Laboratory Director
- TYRONE SNIPES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fruitvale Health Care 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.
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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 | 5 | 0 | 8 | 2 | 9 | 5 | 4 | 7 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 0 | 8 | 4 | 9 | 10 | 4 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 0 + 8 + 4 + 9 + 1 + 0 + 4 + 1 + 4 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1508295478 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1538380969 | STARR LINN STEPHENS P.T. Individual | Physical Therapist | 3020 E 15TH ST OAKLAND, CA 94601 (510) 261-5613 |
| 1275670895 | SSC OAKLAND FRUITVALE OPERATING COMPANY LP Organization | Skilled Nursing Facility | 3020 E 15TH ST OAKLAND, CA 94601 (510) 261-5613 |
| 1215443858 | MR. JUSTIN M RAFFERTY CCC-SLP Individual | Speech-Language Pathologist | 3020 E 15TH ST OAKLAND, CA 94601 (510) 261-5613 |
| 1437719929 | KIMBERLY CHIN Individual | Occupational Therapist | 3020 E 15TH ST OAKLAND, CA 94601 (510) 261-5613 |
| 1144856535 | FRUITVALE OPERATING COMPANY, LP Organization | Skilled Nursing Facility | 3020 E 15TH ST OAKLAND, CA 94601 (510) 261-5613 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508295478, enumerated in the NPI registry as an "organization" on November 01, 2013
The provider is located at 3020 E 15th St Oakland, Ca 94601 and the phone number is (510) 261-5613
This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X
The provider's CLIA number is 05D0883158 for a "skilled nursing facility/nursing facility" 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 November 01, 2013. 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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