KAZAN IVAN W MEMORIAL CLINIC
NPI 1568886000
Clinic/Center - Federally Qualified Health Center (FQHC) in Escalante, UT
NPI Status: Active since February 04, 2014
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- Accepts Insurance
- CLIA Number: 46D0670054
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 04-03-2027
About KAZAN IVAN W MEMORIAL CLINIC
This page provides the complete NPI Profile along with additional information for Kazan Ivan W Memorial Clinic, a primary care provider established in Escalante, Utah operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1568886000 assigned on February 2014. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Kazan Ivan W Memorial Clinic. The authorized official of this NPI record is Evan Christensen (Executive Director)
- NPI
- 1568886000
- Provider Legal Name
- WAYNE COMMUNITY HEALTH CENTERS INC
- Other Organization Name
- KAZAN IVAN W MEMORIAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 570 E MOQUI LN ESCALANTE, UT 84726
- Location Phone
- (435) 826-4374
- Mailing Address
- PO BOX 303 BICKNELL, UT 84715
- Mailing Phone
- (435) 425-3744
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-04-2014
- Last Update Date
- 04-21-2021
- Code Navigator
A primary care provider (PCP) like Kazan Ivan W Memorial Clinic 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 Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- 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 | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay - EPO
- Healthy Premier Silver Standard - EPO
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 |
|---|---|---|---|
| 000055193 | OTHER (01) | UT | MEDICARE PART B - |
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
- 46D0670054
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- April 04, 2025
- Certificate Expiration Date
- April 03, 2027
- Laboratory Director
- WARREN M. BROWN
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Kazan Ivan W Memorial Clinic on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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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 | 6 | 8 | 8 | 8 | 6 | 0 | 0 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 12 | 8 | 16 | 8 | 12 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 2 + 8 + 1 + 6 + 8 + 1 + 2 + 0 + 0 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1568886000 is valid because the calculated check digit 0 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 |
|---|---|---|---|
| 1497096457 | JENNIFER MARIE EVANS PHARMD Individual | Pharmacist | 570 E MOQUI LN ESCALANTE, UT 84726 (435) 826-4374 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568886000, enumerated in the NPI registry as an "organization" on February 04, 2014
The provider is located at 570 E Moqui Ln Escalante, Ut 84726 and the phone number is (435) 826-4374
This medical organization specializes in Clinic/Center with taxonomy code 261QF0400X with a focus in Federally Qualified Health Center (FQHC)
The provider might be accepting Accepts: Aetna CVS Health, Molina Healthcare, University of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 46D0670054 for a "federally qualified health center" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on February 04, 2014. 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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