DESCHUTES JUVENILE DETENTION CENTER CLINIC
NPI 1891450003
Clinic/Center - Multi-Specialty in Bend, OR
NPI Status: Active since November 02, 2021
Contact Information
63360 BRITTA ST STE 1
BEND, OR
ZIP 97703
Phone: (541) 322-7639
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 38D2070191
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-09-2025
About DESCHUTES JUVENILE DETENTION CENTER CLINIC
This page provides the complete NPI Profile along with additional information for Deschutes Juvenile Detention Center Clinic, a provider established in Bend, Oregon operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1891450003 assigned on November 2021. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Deschutes Juvenile Detention Center Clinic. The authorized official of this NPI record is Jonathan Leizman (President)
- NPI
- 1891450003
- Provider Legal Name
- PREMISE HEALTH OF OREGON MEDICAL P C
- Other Organization Name
- DESCHUTES JUVENILE DETENTION CENTER CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 63360 BRITTA ST STE 1 BEND, OR 97703
- Location Phone
- (541) 322-7639
- Mailing Address
- 5500 MARYLAND WAY STE 120 BRENTWOOD, TN 37027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-02-2021
- Last Update Date
- 10-13-2022
- 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
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
- 38D2070191
- Facility Type
- Physician Office
- Certificate Effective Date
- December 10, 2023
- Certificate Expiration Date
- December 09, 2025
- Laboratory Director
- EDWARD PALMER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Deschutes Juvenile Detention Center Clinic 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 | 8 | 9 | 1 | 4 | 5 | 0 | 0 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 18 | 1 | 8 | 5 | 0 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 8 + 1 + 8 + 5 + 0 + 0 + 0 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1891450003 is valid because the calculated check digit 3 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 |
|---|---|---|---|
| 1770606741 | PAIGE AUGUSTA CRISWELL MA, QMHP-C Individual | Counselor (Mental Health) | 63360 BRITTA ST STE 1 BEND, OR 97703 (541) 322-7690 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891450003, enumerated in the NPI registry as an "organization" on November 02, 2021
The provider is located at 63360 Britta St Ste 1 Bend, Or 97703 and the phone number is (541) 322-7639
This medical organization specializes in Clinic/Center with taxonomy code 261QM1300X with a focus in Multi-Specialty
The provider's CLIA number is 38D2070191 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 November 02, 2021. 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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