NPIMap

Organization Active NPI

Community Care Physicians, PLLC

Doing business as Community Care Interventional and Endoscopy Suite

  • Surgery Physician
  • Latham, NY
National Provider Identifier
1083030506
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
198648 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PLLC
Doing business as
Community Care Interventional and Endoscopy Suite
Practice address
6 Wellness Way Ste G04
Latham, NY 12110-2135
Phone
(518) 785-5884
NPI assigned
Mar 7, 2014
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Debby Coons
Title
Credentialing Coordinator
Phone
(518) 213-0478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 198648 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste G04
Latham, NY 12110-2135

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other names 1

  • Community Care Interventional and Endoscopy Suite Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kevin Lau MD121 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

6 Wellness Way
Ste G04
Latham, NY 12110
Phone (518) 785-5884

713 Troy Schenectady Rd
Ste 305
Latham, NY 12110
Phone (518) 262-4942

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1083030506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE G04",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102135",
            "telephone_number": "518-785-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "COONS",
        "authorized_official_first_name": "DEBBY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "518-213-0478"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "198648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Interventional and Endoscopy Suite",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.