NPIMap

Organization Active NPI

North Country Sports Medicine PLLC

  • Orthopaedic Surgery Physician
  • Ticonderoga, NY
National Provider Identifier
1013271550
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
202796 Issued in NY
Legal business name
NORTH COUNTRY SPORTS MEDICINE PLLC
Practice address
1019 Wicker St
Moses Ludington Hospital
Ticonderoga, NY 12883-1039
Phone
(518) 793-9156
Fax
(518) 793-6591
NPI assigned
Jun 29, 2012
Last updated
Jun 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lori M Baldwin
Title
Practice Administrator
Phone
(518) 793-9156

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 202796 NY Primary

Addresses

Primary practice location

1019 Wicker St
Moses Ludington Hospital
Ticonderoga, NY 12883-1039

Mailing address

25 Willowbrook Rd
Suite 2
Queensbury, NY 12804-5882
Phone (518) 793-9156

National Provider Directory

National Provider Directory
Tax ID family
North Country Sports Medicine PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1013271550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK RD",
            "address_2": "SUITE 2",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128045882",
            "telephone_number": "518-793-9156",
            "fax_number": "518-793-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 WICKER ST",
            "address_2": "MOSES LUDINGTON HOSPITAL",
            "city": "TICONDEROGA",
            "state": "NY",
            "postal_code": "128831039",
            "telephone_number": "518-793-9156",
            "fax_number": "518-793-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "518-793-9156"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "202796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ticonderoga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.