NPIMap

Organization Active NPI

Champlain Valley Psychiatric Associates

  • Psychiatry Physician
  • Plattsburgh, NY
National Provider Identifier
1154490944
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CHAMPLAIN VALLEY PSYCHIATRIC ASSOCIATES
Practice address
11 Hammond Lane
Suite a
Plattsburgh, NY 12901-2003
Phone
(518) 561-0063
Fax
(518) 561-0947
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Hal Ira Rubin, MD
Title
Physician Owner Partner
Phone
(518) 561-0063

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X

Addresses

Primary practice location

11 Hammond Lane
Suite a
Plattsburgh, NY 12901-2003

Mailing address

11 Hammond Lane
Suite a
Plattsburgh, NY 12901-2003
Phone (518) 561-0063

Other identifiers 1

IdentifierTypeStateIssuer
GRP490098001OtherNYBLUESHIELD OF NORTHEASTERN NY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1154490944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HAMMOND LANE",
            "address_2": "SUITE A",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012003",
            "telephone_number": "518-561-0063",
            "fax_number": "518-561-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HAMMOND LANE",
            "address_2": "SUITE A",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012003",
            "telephone_number": "518-561-0063",
            "fax_number": "518-561-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPLAIN VALLEY PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "IRA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER PARTNER",
        "authorized_official_telephone_number": "518-561-0063",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD OF NORTHEASTERN NY",
            "identifier": "GRP490098001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.