NPIMap

Organization Active NPI

Community Care Physicians, PC

  • Developmental - Behavioral Pediatrics Physician
  • Latham, NY
National Provider Identifier
1164704136
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
119952 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Practice address
6 Wellness Way Ste 101
Latham, NY 12110-2156
Phone
(518) 782-7733
Fax
(518) 782-0800
NPI assigned
Sep 15, 2011
Organization subpart
Yes
Parent organization
COMMUNITY CARE PHYSICIANS, PCAs reported in NPPES

Authorized official

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

Practitioners 10

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

National Provider Directory

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

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

Locations

7B Johnson Rd
Latham, NY 12110
Phone (518) 782-7733

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0006X 119952 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

6 Wellness Way Ste 101
Latham, NY 12110-2156

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other names 1

NPPES NPI Registry
  • CapitalCare Developmental Pediatrics Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 12, 2024.

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1164704136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "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": "6 WELLNESS WAY STE 101",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-7733",
            "fax_number": "518-782-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE PHYSICIANS, PC",
        "enumeration_date": "2011-09-15",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "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": "2080P0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "119952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CapitalCare Developmental Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.