IDESTA MEDICAL INC
IDESTA MEDICAL INC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1063185015, based in Tyrone, GA. The organization lists 3 taxonomy classifications, with Phlebotomy Technician recorded as primary.
Getting there
The practice address on file is 1015 TYRONE RD # 410-C, Tyrone, GA 30290. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Independent Clinical Laboratory
- PAC ID
- 9537564299
- Enrollment ID
- O20210819000712
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Independent Clinical Laboratory. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Phlebotomy covers
Definition to come... NUCC Health Care Provider Taxonomy, code 246RP1900X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207ZB0001X | Blood Banking & Transfusion Medicine Physician Blood Banking & Transfusion Medicine | — | — | |
| 261Q00000X | Clinic/Center | — | — | |
| 246RP1900X | Phlebotomy Technician Phlebotomy | — | — | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1063185015 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jul 27, 2021 |
| Last updated | Jun 10, 2026 |
| Status | Active |
| Practice address |
1015 TYRONE RD # 410-C Tyrone, GA 30290 (470) 818-2264 Fax (866) 984-3729 |
| Mailing address |
4827 OLD NATIONAL HWY UNIT 2032 College Park, GA 30337 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 6 | 3 | 1 | 8 | 5 | 0 | 1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 3 | 3 | 2 | 8 | 1 | 0 | 2 |
Sum = 45 · next multiple of 10 = 50 · check digit = 5 · actual last digit = 5
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.