Mohawk Valley Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MOHAWK VALLEY NURSING HOME

Practice address

99 6TH Ave
Ilion, NY 13357-1527

Phone

(315) 895-4050

Fax

(315) 895-7197

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ralph P Reid

Title

Ceo

Phone

(315) 895-4050

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1194894022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 6TH AVE",
            "city": "ILION",
            "state": "NY",
            "postal_code": "133571527",
            "telephone_number": "315-895-4050",
            "fax_number": "315-895-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 6TH AVE",
            "city": "ILION",
            "state": "NY",
            "postal_code": "133571527",
            "telephone_number": "315-895-4050",
            "fax_number": "315-895-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAWK VALLEY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-895-4050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473941",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01167977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer P Melnick, RN
• Kysha Messina, LPN
• Dale Robert Miller, PMNHP-BS
• Jonathan Mizgala, DNP, FNP-BC
• Mohawk Valley Counseling Service
• Sara Michael Moran
• Mosaic Health, Inc.
• Jennifer Ann Mueller
• MVNH Associates, LLC
• Tricia Ondrako, LMSW

• Skilled Nursing Facility in Ilion, NY
• Providers in Ilion, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.