Port City Family Medicine P.C. Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PORT CITY FAMILY MEDICINE P.C. INC

Practice address

33 E Schuyler St
Oswego, NY 13126-1161

Phone

(315) 343-6974

Fax

(315) 342-3625

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Corliss Adam Varnum, M.D.

Title

President

Phone

(315) 343-6974

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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

• Jillian Kendrick, FNP-C

  • Family Nurse Practitioner
  • Oswego, NY
  • NPI 1598595480
  Medicare reassignment Care Compare group NPD
• Christina Marie Liepke, M.D.

  • Family Medicine Physician
  • Oswego, NY
  • NPI 1942290358
  Medicare reassignment Care Compare group NPD
• Matthew John Liepke, M.D.

  • Internal Medicine Physician
  • Oswego, NY
  • NPI 1245220656
  Medicare reassignment Care Compare group NPD
• Megan Gallerani

  • Medical Physician Assistant
  • Cortland, NY
  • NPI 1417366642
  Medicare reassignment Care Compare group
• Nicole Michele Furletti, LMHC

  • Mental Health Counselor
  • Oswego, NY
  • NPI 1932773454
  NPD
• North Carl Hauschild, OD OPTOMETRIST

  • Optometrist
  • Auburn, NY
  • NPI 1942278239
  NPD (past)
• Selma Sheridan

  • Ophthalmology Physician
  • Oswego, NY
  • NPI 1093751901
  NPD (past)
• Jayne M. Bernier, M.D.

  • Diagnostic Radiology Physician
  • Clearwater, FL
  • NPI 1063466183
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1215028055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 E SCHUYLER ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261161",
            "telephone_number": "315-343-6974",
            "fax_number": "315-342-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 E SCHUYLER ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261161",
            "telephone_number": "315-343-6974",
            "fax_number": "315-342-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT CITY FAMILY MEDICINE P.C. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "VARNUM",
        "authorized_official_first_name": "CORLISS",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-343-6974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00964989",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen F Pollard, LMSW
• Pontiac Nursing Home LLC
• Port City Chiropractic, PC
• Port City Emergency Physicians LLP
• Port City ENT and Allergy Care P C
• Port City Psychotherapy and Psychological Services
• Susannah Postgate
• Kaylie Marie Potter, OTR/L
• Meredith M Potter, NP-C
• Emily Poulton, M.S. CCC-SLP

• Family Medicine Physician in Oswego, NY
• Providers in Oswego, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.