CANTON-POTSDAM MEDICAL PRACTICE PLLC (NPI# 1760821417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760821417 |
| Entity Type | Organization |
| Organization Name | CANTON-POTSDAM MEDICAL PRACTICE PLLC |
| Practice Address |
80 East Main Street Canton NY 13617 |
| Mailing Address |
50 Leroy St Potsdam NY 13676 |
| Practice Telephone | 3152653300 |
| Practice Fax Number | 3152616025 |
| Mailing Telephone | 3152653300 |
| Mailing Fax Number | 3152616025 |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2018-05-02 |
| Authorized Official Name | ROBERT ROGERS II (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 3152616013 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | PTAN | J100093911 | 01 |
| NY | 03652971 | 05 |
| Street Address |
80 EAST MAIN STREET |
| City | CANTON |
| State | NY |
| Zip Code | 13617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902845621 | Kathleen M Terrence | Pediatrics | 80 East Main Street, Canton, NY 13617 | 2006-06-06 |
| 1912277393 | Robin Eve Gatliardi | Counselor | 80 East Main Street, Suite 255, Canton, NY 13617 | 2012-01-03 |
| 1043367535 | North Country Psychiatric Associates | Clinic/Center | 80 East Main Street, Suite 255, Canton, NY 13617 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1982251740 | Wilma J. Blackmer | Technician | 1756 Cr 14, Canton, NY 13617 | 2019-08-26 |
| 1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
| 1891299608 | Sheena Teresa Smith | Counselor | 310 State Highway 310, Suite 1, Canton, NY 13617 | 2018-03-19 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
| 1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
| 1194061663 | Sarah Prairie | Counselor | 80 State Hwy 310, Suite 1, Canton, NY 13617 | 2013-01-02 |
| 1679859094 | Nathan Ellis | Occupational Therapist | 139 Outer State St. Rd, Canton, NY 13617 | 2011-10-31 |
| 1407139017 | Julianne Rutley | Occupational Therapist | 139 Outer State Street Rd, Canton, NY 13617 | 2011-09-21 |
| Find all providers in zip 13617 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124297163 | Medical Care of Georgia, P.C. | Clinic/Center | 50 Medical Ln, Canton, GA 30114-2417 | 2008-02-25 |
| 1861551822 | St Lawrence County | Clinic/Center | 80 State Highway 310 Ste 2, Canton, NY 13617-1476 | 2006-12-06 |
| 1578129177 | Madison Hma LLC | Clinic/Center | 161 River Oaks Dr, Canton, MS 39046-5375 | 2019-05-20 |
| 1770968943 | Atlantic Medical Group | Clinic/Center | 3501 Lesh St Ne, Canton, OH 44705-4376 | 2015-07-29 |
| 1134321987 | Apex Physical Medicine, Inc | Clinic/Center | 3684 Dressler Rd Nw Ste 2b, Canton, OH 44718-2781 | 2007-06-04 |
| 1598896532 | Downriver Mental Health Clinic | Clinic/Center | 6223 N Canton Center Rd, Suite 210, Canton, MI 48187-2696 | 2007-03-09 |
| 1376559799 | Mercy Medical Center, Inc. | Clinic/Center | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2006-07-31 |
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| 1275172280 | Citimedical Services PC | Clinic/Center | 6336 99th St Fl 1, Rego Park, NY 11374-1979 | 2019-12-23 |
| 1225688419 | Artisans Ambulatory Medical Care Pllc | Clinic/Center | 4521 Arthur Kill Rd Fl 2, Staten Island, NY 10309-1315 | 2019-09-19 |
| 1336799295 | Wellness Medical Services of Manhattan PC | Clinic/Center | 51 E 25th St Ste 499, New York, NY 10010-2945 | 2019-09-12 |
| 1790347243 | Jacob Jacoby Md | Clinic/Center | 100 Route 59 Ste 103, Suffern, NY 10901-4927 | 2019-07-05 |
| 1174089056 | City Medical of Upper East Side, Pllc | Clinic/Center | 216 E 14th St Ste B, New York, NY 10003-4105 | 2019-02-15 |
| 1770051690 | Seagull Medical Services | Clinic/Center | 105 Norwalk Ave, Staten Island, NY 10314-5658 | 2018-11-08 |
| 1093282329 | The Medical Offices of Occupational Health Resources P C | Clinic/Center | 500 W 33rd St, New York, NY 10001-1301 | 2018-10-24 |
| Find all providers with the same taxonomy | ||||
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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.