ROCK OF AGES HOME INC
NPI 1609945005
Assisted Living Facility in Jamestown, ND

NPI Status: Active since November 07, 2006

Contact Information

1315 4TH ST NE
JAMESTOWN, ND
ZIP 58401
Phone: (701) 252-9292
Fax: (701) 252-0417

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 35D0408739
  • CLIA Cert. Type: Other
  • CLIA Exp. Date: 07-28-2025

About ROCK OF AGES HOME INC

This page provides the complete NPI Profile along with additional information for Rock Of Ages Home Inc, a provider established in Jamestown, North Dakota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1609945005 assigned on November 2006. The practitioner's primary taxonomy code is 310400000X with license number 8021B (ND). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Tim M Exner (Administrator Owner)

NPI
1609945005
Provider Name
ROCK OF AGES HOME INC
Entity Type
Organization
Location Address
1315 4TH ST NE JAMESTOWN, ND 58401
Location Phone
(701) 252-9292
Location Fax
(701) 252-0417
Mailing Address
1315 4TH ST NE JAMESTOWN, ND 58401
Mailing Phone
(701) 252-9292
Mailing Fax
(701) 252-0417
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-07-2006
Last Update Date
08-22-2020
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
8021B
License State
ND
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TIM M EXNER

Authorized Official Title
ADMINISTRATOR OWNER
Authorized Official Phone
(701) 252-9292

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
30716MEDICAID (05)ND 

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
35D0408739
Facility Type
Other
Certificate Effective Date
July 29, 2023
Certificate Expiration Date
July 28, 2025
Laboratory Director
JORDAN SHIPLEY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Rock Of Ages Home Inc 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.
1609945005
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
26091841000
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 1 + 8 + 4 + 1 + 0 + 0 + 0 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1609945005 is valid because the calculated check digit 5 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 1609945005, enumerated in the NPI registry as an "organization" on November 07, 2006

The provider is located at 1315 4th St Ne Jamestown, Nd 58401 and the phone number is (701) 252-9292

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

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.

The provider's CLIA number is 35D0408739 for a "other" 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 07, 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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