HUDSON HEADWATERS HEALTH NETWORK (NPI# 1912520636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912520636 |
| Entity Type | Organization |
| Organization Name | HUDSON HEADWATERS HEALTH NETWORK |
| Practice Address |
2249 State Route 86 Ste 3 Saranac Lake NY 12983-5646 |
| Mailing Address |
9 Carey Rd Queensbury NY 12804-7880 |
| Practice Telephone | 5188913845 |
| Practice Fax Number | 5188911236 |
| Mailing Telephone | 5187610300 |
| Mailing Fax Number | 5188242388 |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |
| 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 | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| 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 |
| 1548276801 | Hudson Headwaters Health Network | Family Medicine | 6356 Nys Route 30, Indian Lake, NY 12842-2021 | 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 |
| Street Address |
2249 STATE ROUTE 86 STE 3 |
| City | SARANAC LAKE |
| State | NY |
| Zip Code | 12983-5646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790759017 | Elizabeth K. B. Buck | Internal Medicine | 2249 State Route 86 Ste 3, Saranac Lake, NY 12983-5646 | 2006-02-14 |
| 1922266261 | Brian Guadagno | Internal Medicine | 2249 State Route 86 Ste 3, Saranac Lake, NY 12983-5646 | 2008-05-22 |
| 1699749721 | David Ayrton Johnson | Internal Medicine | 2249 State Route 86 Ste 3, Saranac Lake, NY 12983-5646 | 2006-02-15 |
| 1336113471 | Patricia Kathryn Monroe | Pediatrics | 2249 State Route 86 Ste 3, Saranac Lake, NY 12983-5646 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013486315 | Aisha Dominique Wood | Physical Therapist | 2233 Ny-86, Saranac Lake, NY 12983 | 2018-11-15 |
| 1215357132 | Ashley Garwood | Occupational Therapist | 38 Tahoma Road, Saranac Lake, NY 12983 | 2014-04-17 |
| 1841537982 | Dean Everritt | Social Worker | 33 Depot St., Saranac Lake, NY 12983 | 2013-01-09 |
| 1265797013 | Danielle Carr | Counselor | 28 Bernard Street, Saranac Lake, NY 12983 | 2012-07-09 |
| 1275807489 | Deborah Ann Stevens | Licensed Practical Nurse | 157 Bloomingdale Ave Apt 3, Saranac Lake, NY 12983 | 2012-03-06 |
| 1699085910 | Jessica Evans Jakobe | Speech-Language Pathologist | 141 Petrova Ave, Petrova Elementary, Saranac Lake, NY 12983 | 2010-10-20 |
| 1548407562 | Eve M Burns | Obstetrics & Gynecology | 309 County Route 47 Ste 2, Saranac Lake, NY 12983 | 2009-01-13 |
| 1174735492 | Citizen Advocates Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6 Shepard Ave Apt. 1, Saranac Lake, NY 12983 | 2007-05-07 |
| 1750442513 | High Peaks Hospice and Palliative Care, Inc. | Hospice Care, Community Based | 309 County Route 47 Ste 7, Saranac Lake, NY 12983 | 2006-12-13 |
| 1467536797 | Clifford Gerard Wagner | Chiropractor | 53 Woodruff Street, Saranac Lake, NY 12983 | 2006-10-24 |
| Find all providers in zip 12983 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113346 | Community Pediatrics of Wny, Pllc | Clinic/Center | 741 Davison Rd, Lockport, NY 14094-5214 | 2020-10-27 |
| 1033718085 | Palliative Care Consulting Services | Clinic/Center | 1188 Fox St, Bronx, NY 10459-1810 | 2020-10-21 |
| 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 | SARANAC LAKE |
| Zip Code | 12983 |
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.