HUDSON HEADWATERS HEALTH NETWORK (NPI# 1548276801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548276801 |
| Entity Type | Organization |
| Organization Name | HUDSON HEADWATERS HEALTH NETWORK |
| Practice Address |
6356 Nys Route 30 Indian Lake NY 12842-2021 |
| Mailing Address |
9 Carey Rd Queensbury NY 12804-7880 |
| Practice Telephone | 5186485707 |
| Practice Fax Number | 5186486160 |
| Mailing Telephone | 5187610300 |
| Mailing Fax Number | 5188242388 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-01-31 |
| Authorized Official Name | CHRISTOPHER TOURNIER (EXECUTIVE VP OF FINANCE / CFO) |
| Authorized Official Telephone | 5187610300 |
| Is Organization Subpart | Y |
| Parent Organization Name | HUDSON HEADWATERS HEALTH NETWORK |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03289461 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528611084 | Hudson Headwaters Health Network | Clinic/Center | 27 Hyland Dr, Lake Luzerne, NY 12846-3923 | 2019-07-23 |
| 1780030908 | Hudson Headwaters Health Network | Clinic/Center | 1 Glen St, Glens Falls, NY 12801-4439 | 2016-05-06 |
| 1427452200 | Hudson Headwaters Health Network | Family Medicine | 353 Schroon River Rd, Warrensburg, NY 12885-4807 | 2014-10-22 |
| 1386657534 | Hudson Headwaters Health Network | Nurse Practitioner | 28 S Western Ave, Queensbury, NY 12804-3323 | 2006-08-15 |
| 1952319386 | Hudson Headwaters Health Network | Social Worker | 101 Adirondack Drive, Suite 2, Ticonderoga, NY 12883 | 2006-08-03 |
| 1073529301 | Hudson Headwaters Health Network | Dentist | 3761 Main St, Warrensburg, NY 12885-1837 | 2006-07-31 |
| 1356355952 | Hudson Headwaters Health Network | Family Medicine | 1299 Route 9, Gansevoort, NY 12831-1560 | 2006-07-28 |
| 1295758423 | Hudson Headwaters Health Network | Family Medicine | 11 Cross St, Bolton Landing, NY 12814-0539 | 2006-07-26 |
| 1609899848 | Hudson Headwaters Health Network | Social Worker | 6223 State Route 9, Chestertown, NY 12817-2823 | 2006-07-26 |
| 1346263290 | Hudson Headwaters Health Network | Nurse Practitioner | 1448 Rte 9, South Glens Falls, NY 12803 | 2006-07-25 |
| Street Address |
6356 NYS ROUTE 30 |
| City | INDIAN LAKE |
| State | NY |
| Zip Code | 12842-2021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972029585 | Pawel Patryk Klimkiewicz | Nurse Practitioner | 6356 Nys Route 30, Indian Lake, NY 12842-2021 | 2017-08-15 |
| 1548671886 | Ryan Michael Donnelly | Family Medicine | 6356 Nys Route 30, Indian Lake, NY 12842-2021 | 2014-05-08 |
| 1063524155 | Christopher H Jackson | Physician Assistant | 6356 Nys Route 30, Indian Lake, NY 12842-1500 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417226978 | Renee Ann Blowers | Registered Nurse | 81 White Birch Lane, Indian Lake, NY 12842 | 2011-12-29 |
| 1447408455 | Tracey Hunt | Registered Nurse | 250 White Birch Lane, Indian Lake, NY 12842 | 2008-09-03 |
| 1912295049 | Sherry L Warner | Registered Nurse | 250 White Birch Lane, Indian Lake, NY 12842 | 2011-07-11 |
| 1477701167 | Maria Lourdes Belyea | Registered Nurse | White Birch Lane, Indian Lake, NY 12842 | 2008-09-05 |
| 1649428558 | Jonathan Callahan Stanton | Registered Nurse | 250 White Birch Lane, Indian Lake, NY 12842 | 2008-09-04 |
| 1922394543 | Indian Lake Volunteer Ambulance Corp Inc | Ambulance | 105 Pelon Road, Indian Lake, NY 12842-0117 | 2011-06-22 |
| 1023436334 | Daryl Parslow | Case Manager/Care Coordinator | 139 White Birch Lane, Indian Lake, NY 12842-0139 | 2014-04-03 |
| 1033420963 | Karen Ann Levison | Physical Therapy Assistant | 477 Adirondack Lake Road, Indian Lake, NY 12842-0204 | 2010-06-25 |
| 1013165604 | Beth Waldron | Registered Nurse | 0 White Birch Lane, Indian Lake, NY 12842-0250 | 2008-09-08 |
| 1649428749 | Avis Kim Warner | Registered Nurse | White Birch Lane, Indian Lake, NY 12842-0250 | 2008-09-03 |
| Find all providers in zip 12842 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1821601352 | Xian Medical Care PC | Clinic/Center | 2010 Bay Ridge Pkwy, Brooklyn, NY 11204-5925 | 2020-08-25 |
| 1952920795 | Divine Medical LLC | Clinic/Center | 13163 233rd St # 1, Rosedale, NY 11422-1305 | 2020-04-12 |
| 1972159333 | Ap Medical Care PC | Clinic/Center | 3506 73rd St Ste 2, Jackson Heights, NY 11372-4104 | 2019-08-12 |
| 1982258422 | Schenk Primary Care Medicine, Pllc | Clinic/Center | 2350 Maple Road Suite 100, Amherst, NY 14221 | 2019-08-01 |
| 1356993976 | Mingzhu Medical Office, P.C. | Clinic/Center | 5615 7th Ave Fl 2, Brooklyn, NY 11220-3509 | 2019-07-13 |
| 1417509357 | Henderson Health Services Family Nurse Practitioner Pllc | Clinic/Center | 4 Clarion Dr, White Plains, NY 10603-2868 | 2019-07-11 |
| 1154988897 | Bissalam Medical LLC | Clinic/Center | 3391 3rd Ave Ste 1, Bronx, NY 10456-5355 | 2019-05-28 |
| 1851859961 | Lower Westchester Medical Associates, P.C. | Clinic/Center | 105 Stevens Ave Ste 305306, Mount Vernon, NY 10550-2686 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN LAKE |
| Zip Code | 12842 |
Please comment or provide details below to improve the information on HUDSON HEADWATERS HEALTH NETWORK.
| 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.