NPIMap

Organization Active NPI

Upstate University Clinical Campus Medical Group at Binghamton, Inc.

Doing business as Clinical Campus Medical Services Group

  • Neurology Physician
  • Johnson City, NY
National Provider Identifier
1265987325
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
UPSTATE UNIVERSITY CLINICAL CAMPUS MEDICAL GROUP AT BINGHAMTON, INC.
Doing business as
Clinical Campus Medical Services Group
Practice address
46 Harrison St
Johnson City, NY 13790-2120
Phone
(607) 729-6531
Fax
(607) 217-0110
NPI assigned
Aug 18, 2016
Last updated
Aug 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Dr. Lenore Lynn Boris, JD, PHD
Title
Practice Plan Manager
Phone
(607) 772-3516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

46 Harrison St
Johnson City, NY 13790-2120

Mailing address

425 Robinson St
Binghamton, NY 13904-1735
Phone (607) 772-3516

Other names 1

  • Clinical Campus Medical Services Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1265987325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ROBINSON ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041735",
            "telephone_number": "607-772-3516",
            "fax_number": "607-772-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 HARRISON ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902120",
            "telephone_number": "607-729-6531",
            "fax_number": "607-217-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE UNIVERSITY CLINICAL CAMPUS MEDICAL GROUP AT BINGHAMTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "BORIS",
        "authorized_official_first_name": "LENORE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE PLAN MANAGER",
        "authorized_official_telephone_number": "607-772-3516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "JD, PHD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Campus Medical Services Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.