NPIMap

Organization Active NPI

Ira Davenport Memorial Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Bath, NY
National Provider Identifier
1215021225
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
IRA DAVENPORT MEMORIAL HOSPITAL, INC.
Practice address
7571 State Route 54
Bath, NY 14810-9504
Phone
(607) 776-8500
Fax
(607) 776-8800
NPI assigned
Oct 3, 2006
Last updated
Mar 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Authorized official

Name
Mr. Jonathan I. Lawrence
Title
President & Chief Executive Officer
Phone
(607) 776-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

7571 State Route 54
Bath, NY 14810-9504

Mailing address

7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000724 NY Part B Supplier - Clinic/Group Practice 6406743459 Receives reassigned benefits from 56 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bath, NY

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1215021225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7571 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "14810",
            "telephone_number": "607-776-8500",
            "fax_number": "607-776-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7571 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148109504",
            "telephone_number": "607-776-8500",
            "fax_number": "607-776-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRA DAVENPORT MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "607-776-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.