RIVERSIDE DERMATOLOGY & SPA LLC
NPI 1699262329
Clinic/Center - Multi-Specialty in Hannibal, MO
NPI Status: Active since April 18, 2018
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 26D1096719
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-12-2027
About RIVERSIDE DERMATOLOGY & SPA LLC
This page provides the complete NPI Profile along with additional information for Riverside Dermatology & Spa Llc, a provider established in Hannibal, Missouri operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1699262329 assigned on April 2018. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Linda Cooke Md (Owner)
- NPI
- 1699262329
- Provider Name
- RIVERSIDE DERMATOLOGY & SPA LLC
- Entity Type
- Organization
- Location Address
- 163 MEDICAL DR HANNIBAL, MO 63401
- Location Phone
- (573) 822-4428
- Mailing Address
- 163 MEDICAL DR HANNIBAL, MO 63401
- Mailing Phone
- (573) 822-4428
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-18-2018
- Last Update Date
- 04-18-2018
- 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
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 26D1096719
- Facility Type
- Physician Office
- Certificate Effective Date
- January 13, 2025
- Certificate Expiration Date
- January 12, 2027
- Laboratory Director
- LINDA M. COOKE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Riverside Dermatology & Spa Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that 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 | 6 | 9 | 9 | 2 | 6 | 2 | 3 | 2 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 18 | 9 | 4 | 6 | 4 | 3 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 8 + 9 + 4 + 6 + 4 + 3 + 4 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1699262329 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1679552350 | DR. LINDA M COOKE M.D. Individual | Dermatology | 163 MEDICAL DR HANNIBAL, MO 63401 (573) 248-3900 |
| 1508874736 | KATHLEEN E HAYCRAFT N.P. Individual | Nurse Practitioner | 163 MEDICAL DR HANNIBAL, MO 63401 (573) 248-3900 |
| 1497100713 | KATHERINE GLASER M.D. Individual | Dermatology (MOHS-Micrographic Surgery) | 163 MEDICAL DR HANNIBAL, MO 63401 (573) 719-1818 |
| 1487343810 | DEANA JAMES NP Individual | Nurse Practitioner | 163 MEDICAL DR HANNIBAL, MO 63401 (573) 719-1818 |
| 1396500559 | EMILY ALBRIGHT-ROBERTS NP Individual | Nurse Practitioner | 163 MEDICAL DR HANNIBAL, MO 63401 (573) 719-1818 |
| 1992518658 | INTEGRATED DERMATOLOGY OF NORTHEAST MISSOURI LLC Organization | Dermatology | 163 MEDICAL DR HANNIBAL, MO 63401 (573) 719-1818 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699262329, enumerated in the NPI registry as an "organization" on April 18, 2018
The provider is located at 163 Medical Dr Hannibal, Mo 63401 and the phone number is (573) 822-4428
This medical organization specializes in Clinic/Center with taxonomy code 261QM1300X with a focus in Multi-Specialty
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 26D1096719 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on April 18, 2018. 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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