Active NPI
Hudson Headwaters Health Network
- Nurse Practitioner
- South Glens Falls, NY
National Provider Identifier
1346263290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F334110
- Legal business name
- HUDSON HEADWATERS HEALTH NETWORK
- Practice address
- 1448 Rte 9
South Glens Falls, NY 12803 - Phone
- (518) 761-6961
- Fax
- (518) 761-1006
- NPI assigned
- Jul 25, 2006
- 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
- Eric Burton
- Title
- Chief Financial Officer
- Phone
- (518) 761-0300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F334110 | NY | Primary |
Addresses
Primary practice location
1448 Rte 9
South Glens Falls, NY 12803
Mailing address
1 Broad Street PLZ
PO Box 357
Glens Falls, NY 12801-4390
Phone (518) 761-0300
National Provider Directory
National Provider Directory- Tax ID family
- Hudson Headwaters HLTH
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- Primary Care Clinic/Center
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- Psychiatric/Mental Health Nurse Practitioner
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1346263290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BROAD STREET PLZ",
"address_2": "PO BOX 357",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014390",
"telephone_number": "518-761-0300",
"fax_number": "518-745-1378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1448 RTE 9",
"city": "SOUTH GLENS FALLS",
"state": "NY",
"postal_code": "12803",
"telephone_number": "518-761-6961",
"fax_number": "518-761-1006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUDSON HEADWATERS HEALTH NETWORK",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-25",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BURTON",
"authorized_official_first_name": "ERIC",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "518-761-0300"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "F334110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Glens Falls, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.