NPIMap

Organization Active NPI

Edward John Noble Hospital of Gouverneur Ny

  • Rural Acute Care Hospital
  • Gouverneur, NY
National Provider Identifier
1316940745
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
4423000H Issued in NY
Legal business name
EDWARD JOHN NOBLE HOSPITAL OF GOUVERNEUR NY
Practice address
77 W Barney St
Gouverneur, NY 13642-1040
Phone
(315) 535-9244
Fax
(315) 535-9305
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Patricia Rogers
Title
Patient Accounting Supervisor
Phone
(315) 287-1000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 4423000C NY
Rural Acute Care Hospital 282NR1301X 4423000H NY Primary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X 013468 NY

Addresses

Primary practice location

77 W Barney St
Gouverneur, NY 13642-1040

Mailing address

77 W Barney St
Gouverneur, NY 13642-1040
Phone (315) 287-1000

Other identifiers 2

IdentifierTypeStateIssuer
5805784OtherNCPDP PROVIDER IDENTIFICATION NUMBER
00354256MedicaidNY

Other names 1

  • Edward John Noble Hospital of Gouverneur Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gouverneur Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1316940745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421040",
            "telephone_number": "315-287-1000",
            "fax_number": "315-535-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421040",
            "telephone_number": "315-535-9244",
            "fax_number": "315-535-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD JOHN NOBLE HOSPITAL OF GOUVERNEUR NY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PATIENT ACCOUNTING SUPERVISOR",
        "authorized_official_telephone_number": "315-287-1000"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NY",
            "license": "4423000C",
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "NY",
            "license": "4423000H",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NY",
            "license": "013468",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5805784",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354256",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward John Noble Hospital of Gouverneur",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gouverneur, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.