ROME MEMORIAL HOSPITAL, INC (NPI# 1336100767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336100767 |
| Entity Type | Organization |
| Organization Name | ROME MEMORIAL HOSPITAL, INC |
| Practice Address |
13407 State Route 12 Boonville NY 13309-4954 |
| Mailing Address |
1500 N James St Rome NY 13440-2844 |
| Practice Telephone | 3159423212 |
| Mailing Telephone | 3153387000 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2011-07-25 |
| Authorized Official Name | MR. BASIL ARIGLIO (PRESIDENT/CEO) |
| Authorized Official Telephone | 3153387000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | HMO BLUE | 0009 | 01 |
| NY | MVP | 0392 | 01 |
| NY | CDPHP | 10031973 | 01 |
| NY | 352534 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952362741 | Rome Memorial Hospital, Inc | Clinic/Center | 155 W Dominick St, Rome, NY 13440-5809 | 2006-03-31 |
| 1306807193 | Rome Memorial Hospital, Inc | Clinic/Center | 264 W Dominick St, Rome, NY 13440-5812 | 2006-03-31 |
| 1891113965 | Rome Memorial Hospital, Inc | Clinic/Center | 5 Masonic Ave, Camden, NY 13316-1234 | 2014-04-04 |
| 1356689004 | Rome Memorial Hospital, Inc | Clinic/Center | 1500 N James St, Rome, NY 13440-2844 | 2013-01-30 |
| 1073693420 | Rome Memorial Hospital, Inc | Clinic/Center | 155 W Dominick St, Rome, NY 13440-5809 | 2006-10-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ROME MEMORIAL HOSPITAL, INC. | 1500 N James St, Rome, NY 13440-2844 |
| New York State Corporations | ROME MEMORIAL HOSPITAL, INC. | 1500 North James Street, Rome, Ny 134402899 |
| Street Address |
13407 STATE ROUTE 12 |
| City | BOONVILLE |
| State | NY |
| Zip Code | 13309-4954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336677822 | Corrine Elizabeth Reed | Registered Nurse | 13407 State Route 12, Boonville, NY 13309-4954 | 2017-05-26 |
| 1699155895 | Amanda Lampman | Nurse Practitioner | 13407 State Route 12, Boonville, NY 13309-4954 | 2015-06-02 |
| 1124265749 | Sushma Sapkota Pandey | Internal Medicine | 13407 State Route 12, Boonville Family Care, Boonville, NY 13309 | 2009-01-20 |
| 1144368127 | Ann F Mellen | Nurse Practitioner | 13407 State Route 12, Boonville, NY 13309 | 2007-02-02 |
| 1487678447 | Elizabeth Gleasman | Nurse Practitioner | 13407 State Route 12, Boonville, NY 13309 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447582606 | Jessica M Maurer | Pharmacist | 261 Utica Blvd, Boonville, NY 13309 | 2010-02-12 |
| 1104058791 | Tracy Bova | Registered Nurse | 13407 New York 12, Boonville, NY 13309 | 2009-08-14 |
| 1336347822 | Kph Healthcare Services, Inc. | Pharmacy | 261 Utica Boulevard, Boonville, NY 13309 | 2007-07-05 |
| 1487784278 | Bruce Michael Renders | Dentist | 109 Ann Street, Boonville, NY 13309 | 2007-03-07 |
| 1992870570 | Richard L Sears Thomas N Caruso Dds PC | Dentist | 3 Schuyler St, Boonville, NY 13309 | 2006-11-21 |
| 1003090242 | Michele Van Dreason | Pharmacist | 261 Utica Boulevard, Boonville, NY 13309 | 2007-12-24 |
| 1164465381 | Toby Kevin Davis | Clinical Neuropsychologist | 137 Main St., Boonville, NY 13309-0696 | 2006-06-14 |
| 1487646279 | Mountain Mental Health Group | Social Worker | 120 Schuyler St, Boonville, NY 13309-1005 | 2005-08-17 |
| 1144431511 | Susan Elizabeth Gydesen | Social Worker | 120 Schuyler St, Boonville, NY 13309-1005 | 2007-05-25 |
| 1154489813 | Timothy Francis Dowling | Social Worker | 120 Schuyler St, Boonville, NY 13309-1005 | 2006-12-05 |
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| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.