NPIMap

Organization Active NPI

Community Care Physicians, PC

  • Family Medicine Physician
  • Averill Park, NY
National Provider Identifier
1124309836
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Practice address
3305 Route 43
Averill Park, NY 12018
Phone
(518) 674-5797
Fax
(518) 674-2396
NPI assigned
Sep 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Authorized official

Name
Debby Coons
Title
Credentialing Manager
Phone
(518) 213-0478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3305 Route 43
Averill Park, NY 12018

Mailing address

711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700

Other names 1

  • CapitalCare Familly Medicine Averill Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Hudson Community C121 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1124309836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 ROUTE 43",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "12018",
            "telephone_number": "518-674-5797",
            "fax_number": "518-674-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "COONS",
        "authorized_official_first_name": "DEBBY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-213-0478"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CapitalCare Familly Medicine Averill Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Averill Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.