IVY CREEK PALLIATIVE CARE, LLC
NPI 1639776420
Family Medicine - Hospice and Palliative Medicine in Wetumpka, AL
NPI Status: Active since October 05, 2020
Contact Information
525 HOSPITAL DR STE B
WETUMPKA, AL
ZIP 36092
Phone: (334) 567-5626
- Organization
- Family Medicine
- Hospice and Palliative Medicine
- CLIA Number: 01D2187106
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-24-2026
About IVY CREEK PALLIATIVE CARE, LLC
This page provides the complete NPI Profile along with additional information for Ivy Creek Palliative Care, Llc, a provider established in Wetumpka, Alabama operating as a Family Medicine, focusing in hospice and palliative medicine . The healthcare provider is registered in the NPI registry with number 1639776420 assigned on October 2020. The practitioner's primary taxonomy code is 207QH0002X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Michael D Bruce Ceo (Ceo)
- NPI
- 1639776420
- Provider Name
- IVY CREEK PALLIATIVE CARE, LLC
- Entity Type
- Organization
- Location Address
- 525 HOSPITAL DR STE B WETUMPKA, AL 36092
- Location Phone
- (334) 567-5626
- Mailing Address
- PO BOX 130 WETUMPKA, AL 36092
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-05-2020
- Last Update Date
- 10-05-2020
- 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 Hospice and Palliative Medicine
- Taxonomy Code
- 207QH0002X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area 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
- 01D2187106
- Facility Type
- Physician Office
- Certificate Effective Date
- June 25, 2024
- Certificate Expiration Date
- June 24, 2026
- Laboratory Director
- BRUCE L. KENT
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ivy Creek Palliative Care, 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 | 6 | 3 | 9 | 7 | 7 | 6 | 4 | 2 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 14 | 7 | 12 | 4 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 1 + 4 + 7 + 1 + 2 + 4 + 4 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1639776420 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 1639776420, enumerated in the NPI registry as an "organization" on October 05, 2020
The provider is located at 525 Hospital Dr Ste B Wetumpka, Al 36092 and the phone number is (334) 567-5626
This medical organization specializes in Family Medicine with taxonomy code 207QH0002X with a focus in Hospice and Palliative Medicine
The provider's CLIA number is 01D2187106 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 October 05, 2020. 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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