FIELDCREST MANOR
NPI 1629504600
Nursing Facility/Intermediate Care Facility in Manitowoc, WI
NPI Status: Active since May 11, 2017
- Organization
- Nursing Facility/Intermediate Care Facil...
- CLIA Number: 52D2234017
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 08-26-2025
About FIELDCREST MANOR
This page provides the complete NPI Profile along with additional information for Fieldcrest Manor, a provider established in Manitowoc, Wisconsin operating as a Nursing Facility/intermediate Care Facility. The healthcare provider is registered in the NPI registry with number 1629504600 assigned on May 2017. The practitioner's primary taxonomy code is 313M00000X with license number 0016554 (WI). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Fieldcrest Manor. The authorized official of this NPI record is Mr. Dean C Maschoff (President)
- NPI
- 1629504600
- Provider Legal Name
- NORTH OAK HEALTH CARE, INC.
- Other Organization Name
- FIELDCREST MANOR
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1510 S 30TH ST MANITOWOC, WI 54220
- Location Phone
- (920) 682-8980
- Mailing Address
- 1025 SHERMER RD NORTHBROOK, IL 60062
- Mailing Phone
- (847) 612-0750
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-11-2017
- Last Update Date
- 05-11-2017
- 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
Nursing Facility/Intermediate Care Facility
- Taxonomy Code
- 313M00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 0016554
- License State
- WI
- Taxonomy Description
- An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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
- 52D2234017
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- August 27, 2023
- Certificate Expiration Date
- August 26, 2025
- Laboratory Director
- CORY KATSMA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fieldcrest Manor 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 | 6 | 2 | 9 | 5 | 0 | 4 | 6 | 0 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 10 | 0 | 8 | 6 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 1 + 0 + 0 + 8 + 6 + 0 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1629504600 is valid because the calculated check digit 0 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 1629504600, enumerated in the NPI registry as an "organization" on May 11, 2017
The provider is located at 1510 S 30th St Manitowoc, Wi 54220 and the phone number is (920) 682-8980
This medical organization specializes in Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X
The provider's CLIA number is 52D2234017 for a "assisted living 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 May 11, 2017. 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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