Hudson Headwaters Health Network

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HUDSON HEADWATERS HEALTH NETWORK

Practice address

1305 Route 9
Gansevoort, NY 12831

Phone

(888) 291-9195

Fax

(518) 478-6264

NPI assigned

Jul 5, 2023

Organization subpart

No

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

• Hudson Headwaters Health Network

  • Community/Retail Pharmacy
  • Salem, NY
  • NPI 1194610717

  O20240724000299

  Same enrollment

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

Medicare medical equipment & supply locations

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

Hudson Headwaters HLTH43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Malone, NY
  • NPI 1003691064
  NPD tax ID
• Hudson Headwaters Health Network

  • Community/Retail Pharmacy
  • Malone, NY
  • NPI 1003798943
  NPD tax ID
• Hudson Headwaters Health Network

  • Clinical Medical Laboratory
  • Warrensburg, NY
  • NPI 1003829250
  NPD tax ID
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Queensbury, NY
  • NPI 1013292002
  NPD tax ID
• Hudson Headwaters Health Network

  • Physician Assistant
  • Queensbury, NY
  • NPI 1043232051
  NPD tax ID
• Hudson Headwaters Health Network

  • Internal Medicine Physician
  • Glens Falls, NY
  • NPI 1114937877
  NPD tax ID
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Fort Edward, NY
  • NPI 1124320247
  NPD tax ID
• Hudson Headwaters Health Network

  • Physician Assistant
  • Indian Lake, NY
  • NPI 1154343168
  NPD tax ID
• Hudson Headwaters Health Network

  • Federally Qualified Health Center (FQHC)
  • Glens Falls, NY
  • NPI 1154589083
  NPD tax ID
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Plattsburgh, NY
  • NPI 1164998423
  NPD tax ID
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Tupper Lake, NY
  • NPI 1174146898
  NPD tax ID
• Hudson Headwaters Health Network

  • Psychiatric/Mental Health Nurse Practitioner
  • Glens Fall, NY
  • NPI 1184651317
  NPD tax ID

Locations

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

Authorized official

Name

Joel Wright

Title

President Pharmacy Services

Phone

(806) 242-7782

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hudson Headwaters Pharmacy Doing business as

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1245917871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S POLK ST STE 200",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791011436",
            "telephone_number": "806-242-7782",
            "fax_number": "518-478-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 ROUTE 9",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "12831",
            "telephone_number": "888-291-9195",
            "fax_number": "518-478-6264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON HEADWATERS HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT PHARMACY SERVICES",
        "authorized_official_telephone_number": "806-242-7782"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08089521",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Headwaters Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hudson Headwaters Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Salam Hawa, MD
• Jami Hawthorne
• Andrea Grace Hennessy, FNP
• Jillian Elyse Herrington, PNP
• Lisa Marie Howes, RN
• Hudson Headwaters Health Network
• Jessica Lynn Hume, FNP-C
• Danielle Insco
• Monica Marie Isenovski, MA, CCC-SLP
• Gabriella Izzo, MD

• All providers in Gansevoort, NY
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.