COUNTRY DOCTOR COMMUNITY CLINIC
NPI 1629055900
Case Management in Seattle,


Quality Rating: 100 out of 100 score

NPI Status: Active since December 28, 2005

Contact Information

2101 E Yesler Way
Seattle,
Post Code: 98122
Phone: (206) 709-7112
Fax: (209) 299-1920

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Country Doctor Community Clinic in Seattle - Case Management

Country Doctor Community Clinic is a Case Management in Seattle, . Country Doctor Community Clinic practices all healthcare services and medical treatments related to Case Management. The NPI Number for Country Doctor Community Clinic is 1629055900. The last update date is 2024-05-20.

Country Doctor Community Clinic's current location address is 2101 E Yesler Way, Seattle, . You can contact this provider via phone number (206) 709-7112 and fax number (209) 299-1920. The mailing address for Country Doctor Community Clinic is 2101 E Yesler Way, Seattle, . To know further, please read the information below!

About GREGORY MERRITT

NPI
1629055900
Provider Legal Name
SEATTLE ROOTS COMMUNITY HEALTH
Other Organization Name
COUNTRY DOCTOR COMMUNITY CLINIC
Other Name Type
Doing Business As(3)
Entity Type
Organization
Location Address
2101 E Yesler Way, Seattle,
Location Phone
(206) 709-7112
Location Fax
(209) 299-1920
Mailing Address
500 19th Ave E, Seattle, Washington(WA)
Mailing Phone
206-299-1600
Mailing Fax
206-299-1608
Enumeration Date
2005-12-28
Last Update Date
2024-05-20
Code Navigator

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, Federally Qualified Health Center (FQHC)

Taxonomy Code
261QF0400X
Type
-
License No.
-
License State
-
Taxonomy Description
-

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1 251B00000X Case Management Agency

Case Management

()
2 261QC1500X Community Health Clinic/Center

Clinic/Center, Community Health

601583685 (Washington)

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
1014895 MEDICAID (05) Washington (WA)
16943 Other (non-Medicare) (01) Washington (WA) L&I
600508852 Other (non-Medicare) (01) Washington (WA) UBI
6013965 MEDICAID (05) Washington (WA)
6014948 MEDICAID (05) Washington (WA)
7034044 MEDICAID (05) Washington (WA)
7034598 MEDICAID (05) Washington (WA)
7590243 MEDICAID (05) Washington (WA)
7900632 MEDICAID (05) Washington (WA)
8016081 MEDICAID (05) Washington (WA)
8016438 MEDICAID (05) Washington (WA)
8064602 MEDICAID (05) Washington (WA)

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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.
1629055900
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2649051090
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. 2649051090
2 + 6 + 4 + 9 + 0 + 5 + 1 + 0 + 9 + 0 + 24 = 60
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
0

The NPI number 1629055900 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1265435218 CAREY LEEDS
Individual
Obstetrics & Gynecology 803 E LINCOLN AVE
SUNNYSIDE, Washington (WA)
509-837-1550
1508869546 MATTHEW CHARLES BROUNS
Individual
Internal Medicine, Hematology & Oncology 210 SE 136TH AVE
VANCOUVER, Washington (WA)
360-944-9889
1376546309 EDWARD HSIA0-KUA CHANG
Individual
Internal Medicine, Hematology & Oncology 12123 SW 69TH AVE
TIGARD, Oregon (OR)
971-708-7600
1194728329 JOHN J LOFFARELLI
Individual
Internal Medicine 820 N CHELAN AVE
WENATCHEE, Washington (WA)
509-663-8711
1285637298 DIVIS K KHAIRA
Individual
Internal Medicine 1615 DELAWARE ST
LONGVIEW, Washington (WA)
360-414-7878