NPIMap

Organization Active NPI

Claxton Hepburn Medical Center

  • Rural Health Clinic/Center
  • Heuvelton, NY
National Provider Identifier
1104402239
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CLAXTON HEPBURN MEDICAL CENTER
Practice address
103 Rensselaer St
Heuvelton, NY 13654-3137
Phone
(315) 344-6621
Fax
(315) 713-6510
NPI assigned
Mar 19, 2021
Organization subpart
Yes
Parent organization
CLAXTON HEPBURN MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Authorized official

Name
Rob Bloom
Title
Cfo
Phone
(315) 713-5202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

103 Rensselaer St
Heuvelton, NY 13654-3137

Mailing address

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 713-5354

Other names 1

  • Heuvelton Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Claxton Hepburn Medical Center4 organizations share this tax ID, including this one
Part of
Claxton Hepburn Medical Center

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1104402239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 KING ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691142",
            "telephone_number": "315-713-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 RENSSELAER ST",
            "city": "HEUVELTON",
            "state": "NY",
            "postal_code": "136543137",
            "telephone_number": "315-344-6621",
            "fax_number": "315-713-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAXTON HEPBURN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAXTON HEPBURN MEDICAL CENTER",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-713-5202"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heuvelton Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heuvelton Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heuvelton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.