Organization Active NPI

Internal Medicine of Northern New York

  • Internal Medicine Physician
  • Watertown, NY
National Provider Identifier
1174525547
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE OF NORTHERN NEW YORK
Practice address
53-59 Public SQ
Suite 201
Watertown, NY 13601
Phone
(315) 782-4950
Fax
(315) 782-3699
NPI assigned
Aug 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Frank Rhode, MDNPI 1720080187
Title
President
Phone
(315) 782-4950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X NY Primary

Addresses

Primary practice location

53-59 Public SQ
Suite 201
Watertown, NY 13601

Mailing address

53-59 Public SQ
Suite 201
Watertown, NY 13601-2674
Phone (315) 782-4950

National Provider Directory

National Provider Directory

Locations

53-59 Public Sq
Ste 201
Watertown, NY 13601
Phone (315) 782-4950

Practitioners & affiliated clinicians

Practitioners 1

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": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174525547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53-59 PUBLIC SQ",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012674",
            "telephone_number": "315-782-4950",
            "fax_number": "315-782-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53-59 PUBLIC SQ",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-782-4950",
            "fax_number": "315-782-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF NORTHERN NEW YORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RHODE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-782-4950",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.