NPIMap

Organization Active NPI

Community Care Physicians, PC

Doing business as CapitalCare Family Practice Ravena

  • Family Medicine Physician
  • Ravena, NY
National Provider Identifier
1093097586
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
192285 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Doing business as
CapitalCare Family Practice Ravena
Practice address
2524 US Route 9W
Ravena, NY 12143-2804
Phone
(518) 756-7390
Fax
(518) 756-8030
NPI assigned
Sep 12, 2011
Last updated
Mar 14, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CARE PHYSICIANS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 192285 NY Primary

Addresses

Primary practice location

2524 US Route 9W
Ravena, NY 12143-2804

Mailing address

711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700

Other names 1

  • CapitalCare Family Practice Ravena Doing business as

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

Locations

2524 US Route 9W
Ravena, NY 12143
Phone (518) 756-7390

NPI Registry JSON

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1093097586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "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": "2524 US ROUTE 9W",
            "city": "RAVENA",
            "state": "NY",
            "postal_code": "121432804",
            "telephone_number": "518-756-7390",
            "fax_number": "518-756-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE PHYSICIANS, PC",
        "enumeration_date": "2011-09-12",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "COONS",
        "authorized_official_first_name": "DEBBY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-213-0478"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "192285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CapitalCare Family Practice Ravena",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ravena, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.