NPIMap

Organization Active NPI

Hudson Headwaters Health Network

  • Internal Medicine Physician
  • Glens Falls, NY
National Provider Identifier
1114937877
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
223786 Issued in NY
Legal business name
HUDSON HEADWATERS HEALTH NETWORK
Practice address
100 Broad St
Glens Falls, NY 12801-4349
Phone
(518) 792-2223
Fax
(518) 792-8231
NPI assigned
Aug 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Eric Burton
Title
Chief Financial Officer
Phone
(518) 761-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 223786 NY Primary

Addresses

Primary practice location

100 Broad St
Glens Falls, NY 12801-4349

Mailing address

1 Broad Street PLZ
PO Box 357
Glens Falls, NY 12801-4390
Phone (518) 761-0300

National Provider Directory

National Provider Directory
Tax ID family
Hudson Headwaters HLTH43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114937877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROAD STREET PLZ",
            "address_2": "PO BOX 357",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014390",
            "telephone_number": "518-761-0300",
            "fax_number": "518-745-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROAD ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014349",
            "telephone_number": "518-792-2223",
            "fax_number": "518-792-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON HEADWATERS HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "518-761-0300"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "223786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.