North Country Sports Medicine PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

NORTH COUNTRY SPORTS MEDICINE PLLC

Practice address

25 Willowbrook Road
Suite 2
Queensbury, NY 12804

Phone

(518) 793-9156

Fax

(518) 793-6591

NPI assigned

Oct 19, 2006

Last updated

Sep 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lori M Baldwin

Title

Practice Administrator

Phone

(518) 793-9156

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1144302217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK ROAD",
            "address_2": "SUITE 2",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "12804",
            "telephone_number": "518-793-9156",
            "fax_number": "518-793-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK ROAD",
            "address_2": "SUITE 2",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "12804",
            "telephone_number": "518-793-9156",
            "fax_number": "518-793-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "518-793-9156",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02194627",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Nichols, D.C.
• Julia Marie Niedziejko, OTR/L
• Noah Reiss MD PC
• Harvey W Noordsy, STM
• North Country ENT, PC
• North Country Vision Center
• Helen Margaret Nutt, FNP-C
• Lauren Alexis O'Connor
• Shannon L O'Hara, PT
• O'Leary Chiropractic, PLLC

• Orthopaedic Surgery Physician in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Orthopaedic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.