Organization Active NPI

Southern Adirondack Family Health-NP, PLLC

Doing business as Southern Adirondack Family Health-NP

  • Primary Care Clinic/Center
  • Queensbury, NY
National Provider Identifier
1073227856
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SOUTHERN ADIRONDACK FAMILY HEALTH-NP, PLLC
Doing business as
Southern Adirondack Family Health-NP
Practice address
375 Bay Rd Ste 101
Queensbury, NY 12804-3012
Phone
(518) 932-7234
NPI assigned
Jan 6, 2023
Last updated
Mar 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Authorized official

Name
Kathleen M Emerson, NPNPI 1326523176
Title
FNP
Phone
(518) 932-7234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

375 Bay Rd Ste 101
Queensbury, NY 12804-3012

Mailing address

375 Bay Rd Ste 101
Queensbury, NY 12804-3012
Phone (518) 932-7234

Other names 1

  • Southern Adirondack Family Health-NP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230426000735 NY Part B Supplier - Clinic/Group Practice 5092170068 Receives reassigned benefits from 3 practitioners
Practice locations: Queensbury, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2278322Southern Adirondack Family Health - NP PLLC375 Bay Rd - Suite 101, Queensbury, NY 12804Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

375 Bay Rd
Ste 101
Queensbury, NY 12804
Phone (518) 793-4910

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1073227856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 BAY RD STE 101",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043012",
            "telephone_number": "518-932-7234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 BAY RD STE 101",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043012",
            "telephone_number": "518-932-7234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ADIRONDACK FAMILY HEALTH-NP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "518-932-7234",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Adirondack Family Health-NP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Adirondack Family Health-NP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.