Active NPI
North Country Medicine PLLC
- General Practice Physician
- Glens Falls, NY
National Provider Identifier
1346463940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- NORTH COUNTRY MEDICINE PLLC
- Practice address
- 461 Glen St
Glens Falls, NY 12801-2906 - Phone
- (518) 745-5889
- Fax
- (518) 745-0010
- NPI assigned
- Apr 11, 2007
- 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
- Dr. Diane Marie Macdonnell, M.D.
- Title
- Proprietor
- Phone
- (518) 745-5889
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
461 Glen St
Glens Falls, NY 12801-2906
Mailing address
461 Glen St
Glens Falls, NY 12801-2906
Phone (518) 745-5889
Other names 1
- North Country Holistic Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070822000669 | NY | Part B Supplier - Clinic/Group Practice | 7810089885 |
Receives reassigned benefits from 2 practitioners Practice locations: Glens Falls, NY |
National Provider Directory
National Provider DirectoryLocations
461 Glen St
Glens Falls, NY 12801
Phone (518) 744-2712
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Saratoga Springs, NY
- NPI 1063501443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187654400000",
"number": "1346463940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 GLEN ST",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128012906",
"telephone_number": "518-745-5889",
"fax_number": "518-745-0010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 GLEN ST",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128012906",
"telephone_number": "518-745-5889",
"fax_number": "518-745-0010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH COUNTRY MEDICINE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-11",
"last_updated": "2007-08-21",
"status": "A",
"authorized_official_last_name": "MACDONNELL",
"authorized_official_first_name": "DIANE",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "PROPRIETOR",
"authorized_official_telephone_number": "518-745-5889",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "North Country Holistic Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in 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 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.