Sun River Health Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SUN RIVER HEALTH INC.

Practice address

807 Main St
Hudson River Healthcare, Inc.
Peekskill, NY 10566-2040

Phone

(914) 788-5251

Fax

(914) 788-3963

NPI assigned

Dec 21, 2006

Last updated

Mar 11, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SUN RIVER HEALTH INC.As reported in NPPES

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

Authorized official

Name

Adam Lipton

Title

VP Info/Practice MGMT Systems

Phone

(914) 384-2375

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093879173. Details of each certification follow.

• CCN 331923 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 331923

Legal name

HUDSON RIVER COMMUNITY HEALTHCARE-BOHLMAN TOWERS

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 15, 2004

Last certification

Jan 15, 2004

Ownership / control type

For profit – corporation

Facility address

807 Main Street
Peekskill, NY 10566

Part of

Michael J Gallina

Practitioners 1

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.

• Dillard Elmore, D.O., MBA

  • Family Medicine Physician
  • Southampton, PA
  • NPI 1841225554
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1093879173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5036",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106025036",
            "telephone_number": "914-734-8800",
            "fax_number": "914-734-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 MAIN ST",
            "address_2": "HUDSON RIVER HEALTHCARE, INC.",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662040",
            "telephone_number": "914-788-5251",
            "fax_number": "914-788-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN RIVER HEALTH INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN RIVER HEALTH INC.",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "LIPTON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "VP INFO/PRACTICE MGMT SYSTEMS",
        "authorized_official_telephone_number": "914-384-2375"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Stingle, RDN, CDN
• Jennifer Stolzenberg
• Stowe Road Dental PLLC
• Ryang J. Suh, M.D.
• John Michael Sullivan, L.C.S.W., C.A.S.A.C.
• Sun River Health Inc.
• Miriam Surval, CSW
• Melanie Sussman
• Lindsay Sutton
• Kathleen E. Talbot, LCSW

• Federally Qualified Health Center (FQHC) in Peekskill, NY
• Providers in Peekskill, NY by specialty
• Federally Qualified Health Center (FQHC) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.