NPIMap

Organization Active NPI

Family & Children'S Service of Ithaca Inc

  • Voluntary or Charitable Agency
  • Ithaca, NY
National Provider Identifier
1124176680
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
7583100A Issued in NY
Legal business name
FAMILY & CHILDREN'S SERVICE OF ITHACA INC
Practice address
127 W State St FL 1
Ithaca, NY 14850-5427
Phone
(607) 273-7494
Fax
(607) 273-7484
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Authorized official

Name
Ms. Alicia KenaleyNPI 1154503829
Title
Executive Director
Phone
(607) 273-7494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 7583100A NY Primary

Addresses

Primary practice location

127 W State St FL 1
Ithaca, NY 14850-5427

Mailing address

127 W State St FL 1
Ithaca, NY 14850-5427
Phone (607) 273-7494

Other identifiers 1

IdentifierTypeStateIssuer
00843476MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510001270 NY Part B Supplier - Clinic/Group Practice 0446249957 Receives reassigned benefits from 14 practitioners
Practice locations: Ithaca, NY

National Provider Directory

National Provider Directory

Locations

127 W State St
Ithaca, NY 14850
Phone (607) 273-7494

127 W State St
Fl 1
Ithaca, NY 14850
Phone (607) 273-7494

521 W Seneca St
Ste 23
Ithaca, NY 14850
Phone (607) 273-1129

Practitioners & affiliated clinicians

Practitioners 91

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671494400000",
    "number": "1124176680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W STATE ST FL 1",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505427",
            "telephone_number": "607-273-7494",
            "fax_number": "607-273-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W STATE ST FL 1",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505427",
            "telephone_number": "607-273-7494",
            "fax_number": "607-273-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY & CHILDREN'S SERVICE OF ITHACA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A",
        "authorized_official_last_name": "KENALEY",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "607-273-7494",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NY",
            "license": "7583100A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00843476",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.