NPIMap

Organization Active NPI

New York State

  • Case Management Agency
  • Canandaigua, NY
National Provider Identifier
1215112768
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
CAH00066 Issued in NY
Legal business name
NEW YORK STATE
Practice address
5259 Parkside Dr
Canandaigua, NY 14424-7507
Phone
(518) 457-9835
NPI assigned
Jan 3, 2008
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
NEW YORK STATEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Karla Smith
Title
Director of Central Operations
Phone
(518) 402-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X CAH00066 NY Primary

Addresses

Primary practice location

5259 Parkside Dr
Canandaigua, NY 14424-7507

Mailing address

44 Holland Ave
Albany, NY 12229-0001

Other identifiers 1

IdentifierTypeStateIssuer
01742992MedicaidNY

Other names 1

  • CAH Finger Lakes DDSO Other name

National Provider Directory

National Provider Directory
Tax ID family
Wilton Devel Ctr Rev M269 organizations share this tax ID, including this one
Part of
Wilton Devel Ctr Rev M

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1215112768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122290001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5259 PARKSIDE DR",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247507",
            "telephone_number": "518-457-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK STATE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW YORK STATE",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "DIRECTOR OF CENTRAL OPERATIONS",
        "authorized_official_telephone_number": "518-402-4333"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NY",
            "license": "CAH00066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01742992",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAH Finger Lakes DDSO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.