ST REGIS MOHAWK TRIBE (NPI# 1457344558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457344558 |
| Entity Type | Organization |
| Organization Name | ST REGIS MOHAWK TRIBE |
| Other Organization Name | ST REGIS MOHAWK HEALTH SERVICES |
| Practice Address |
412 State Route 37 Akwesasne NY 13655-3109 |
| Practice Telephone | 5183583141 |
| Practice Fax Number | 5183582797 |
| Mailing Telephone | 5183583141 |
| Mailing Fax Number | 5183582797 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. BARBARA LAZORE (TRIBAL CHIEF) |
| Authorized Official Telephone | 5183583141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
1653200R | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00651785 | 05 | |
| NY | 01178234 | 05 |
| Other Name | Type Code |
|---|---|
| ST REGIS MOHAWK HEALTH SERVICES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659521052 | St Regis Mohawk Tribe | Substance Abuse Rehabilitation Facility | 412 State Route 37, Akwesasne, NY 13655-3109 | 2008-09-23 |
| 1053432195 | St Regis Mohawk Tribe | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 412 State Route 37, Akwesasne, NY 13655-3109 | 2007-04-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST REGIS MOHAWK TRIBE | 412 State Rte 37, Hogansburg, NY 13655-3109 |
| Street Address |
412 STATE ROUTE 37 |
| City | AKWESASNE |
| State | NY |
| Zip Code | 13655-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003253428 | Deborah A Fent | Dental Hygienist | 412 State Route 37, Akwesasne, NY 13655-3109 | 2013-05-24 |
| 1659521052 | St Regis Mohawk Tribe | Substance Abuse Rehabilitation Facility | 412 State Route 37, Akwesasne, NY 13655-3109 | 2008-09-23 |
| 1952573164 | Ellen Maxine Cook Barnes | Counselor | 412 State Route 37, Akwesasne, NY 13655-3109 | 2008-03-27 |
| 1053432195 | St Regis Mohawk Tribe | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 412 State Route 37, Akwesasne, NY 13655-3109 | 2007-04-03 |
| 1558497321 | Alexandra Marie Cook | Counselor | 412 State Route 37, Akwesasne, NY 13655-3109 | 2007-02-26 |
| 1568598233 | Jill Conrad | Counselor | 412 State Route 37, Akwesasne, NY 13655-3109 | 2007-02-26 |
| 1508920430 | Thomas Albert Saxby | Pharmacist | 412 State Route 37, Akwesasne, NY 13655-3109 | 2006-12-22 |
| 1700940632 | Brian Wayne Bond | Pharmacist | 412 State Route 37, Akwesasne, NY 13655-3109 | 2006-12-22 |
| 1790849800 | Christine L. Venery | Counselor | 412 State Route 37, Akwesasne, NY 13655-3109 | 2006-12-21 |
| 1255495230 | Anita M. Plann | Counselor | 412 State Route 37, Akwesasne, NY 13655-3109 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225651946 | Elizabeth Marie Eggleston | Social Worker | Saint Regis Mohawk Tribe Health Services, 404 State Route 37, Hogansburg, NY 13655 | 2020-05-28 |
| 1093206732 | Heather Marie Pontius | Dietitian, Registered | 378 State Route 37, Hogansburg, NY 13655 | 2018-05-29 |
| 1548400690 | Melissa Ann Dalton | Technician/Technologist | 155 State Route 37, Hogansburg, NY 13655 | 2009-03-03 |
| 1730329848 | Barbara George | Technician/Technologist | 346 St.regis Road, Akwesasne, NY 13655 | 2009-03-02 |
| 1225183577 | Hillary Jill Pyke | Optometrist | 997 State Rte 37, Hogansburg, NY 13655 | 2007-01-25 |
| 1871663294 | Katherine R Henderson | Counselor | 404 State Route 37, Hogansburg, NY 13655 | 2006-11-09 |
| 1538783220 | Trish D Keese | Counselor | 404 State Route 37, Hogansburg, NY 13655 | 2020-05-29 |
| 1265056956 | Connie M Thompson | Counselor | 404 State Route 37, Hogansburg, NY 13655 | 2020-05-29 |
| 1457975138 | Brittany L Benedict | Counselor | 404 State Route 37, Hogansburg, NY 13655 | 2020-05-29 |
| 1063035582 | Saint Regis Mohawk Tribe | Health Educator | 404 State Route 37, Hogansburg, NY 13655 | 2020-05-19 |
| Find all providers in zip 13655 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| 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.