Active NPI
Ira Davenport Hospital
- Dentist
- Bath, NY
National Provider Identifier
1215058771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- IRA DAVENPORT HOSPITAL
- Practice address
- 7571 State Route 54
Bath, NY 14810-9504 - Phone
- (607) 776-8931
- Fax
- (607) 776-8800
- NPI assigned
- Apr 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Smith
- Title
- Cfo
- Phone
- (607) 776-8508
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | Primary |
Addresses
Primary practice location
7571 State Route 54
Bath, NY 14810-9504
Mailing address
7571 State Route 54
Bath, NY 14810-9504
Phone (607) 776-8931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Medicare Defined Swing Bed Hospital Unit
- Bath, NY
- NPI 1215021225
O20040303000724
-
- Rural Acute Care Hospital
- Bath, NY
- NPI 1306930318
O20040303000724
-
- Skilled Nursing Facility
- Bath, NY
- NPI 1922192939
O20040303000724
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1215058771",
"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": "148109504",
"telephone_number": "607-776-8931",
"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": "607-776-8931",
"fax_number": "607-776-8800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IRA DAVENPORT HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "607-776-8508"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"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 Aug 22, 2020; 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.