County of Otsego

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

3824901L Issued in NY

Legal business name

COUNTY OF OTSEGO

Practice address

128 Phoenix Mills Cross Rd
Cooperstown, NY 13326-5716

Phone

(607) 544-2684

Fax

(607) 544-2716

NPI assigned

Feb 5, 2007

Organization subpart

Yes

Parent organization

COUNTY OF OTSEGOAs reported in NPPES

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

Authorized official

Name

Mary Reitz, RN

Title

Director of Patient Services

Phone

(607) 544-2684

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• OTSEGO MANOR LTHHCP Doing business as

Part of

Ostego MNTL HLTH SVC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• County of Otsego

  • Land Ambulance
  • Cooperstown, NY
  • NPI 1801555214

  Member Of

  NPD member

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1093854564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PHOENIX MILLS CROSS RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133265716",
            "telephone_number": "607-544-2684",
            "fax_number": "607-544-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 PHOENIX MILLS CROSS RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133265716",
            "telephone_number": "607-544-2684",
            "fax_number": "607-544-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF OTSEGO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF OTSEGO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "REITZ",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT SERVICES",
        "authorized_official_telephone_number": "607-544-2684",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "3824901L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01204053",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OTSEGO MANOR LTHHCP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cooperstown Optical LLC
• Lynn Carol Coppolo, RN,CDE
• Katrina Ann Hayag Corpuz, MD
• Trista Corsino
• Nancy Coulehan, R.D., C.D.E.
• County of Otsego
• County of Otsego
• County of Otsego
• Lindsey Marie Coutlee, FNP-C
• Jill C. Craig, D.C.

• All providers in Cooperstown, NY
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.