Faxton St Lukes Healthcare

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

FAXTON ST LUKES HEALTHCARE

Practice address

2150 Bleecker St
Utica, NY 13501-1738

Phone

(315) 624-6000

NPI assigned

Jul 23, 2007

Organization subpart

Yes

Parent organization

FAXTON ST LUKES HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Cody White

Title

Revenue Cycle Director

Phone

(315) 801-4429

Specialties & licenses 1

Addresses

Electronic endpoints 1

Part of

MVHS Inc

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1124228770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4849",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135044849",
            "telephone_number": "315-624-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 BLEECKER ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011738",
            "telephone_number": "315-624-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAXTON ST LUKES HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAXTON ST LUKES HEALTHCARE",
        "enumeration_date": "2007-07-23",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "315-801-4429"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maria Ann Fanelli, M.S., CCC-SLP
• Mike Joseph Fanelli, DDS
• Sandra L Farnell, LMHC
• Elizabeth A Farnum, MD
• Verne Franklin Faulkner
• Faxton St Lukes Healthcare
• Faxton St Lukes Healthcare
• Faxton St. Luke'S Healthcare
• Faxton-St. Lukes Healthcare
• Faxton-Sunset St. Luke'S Health Care Center Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Utica, NY
• Providers in Utica, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.