Organization Active NPI

Crotched Mountain Community Services

  • Home Health Agency
  • Albany, NY
National Provider Identifier
1356493894
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CROTCHED MOUNTAIN COMMUNITY SERVICES
Practice address
1873 Western Ave
Albany, NY 12203-5028
Phone
(518) 452-1214
Fax
(518) 452-3546
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Donald Shumway
Title
President & Ceo
Phone
(603) 547-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NY Primary

Addresses

Primary practice location

1873 Western Ave
Albany, NY 12203-5028

Mailing address

1 Verney Dr
Crotched Mountain Foundation
Greenfield, NH 03047-5000
Phone (603) 547-3311

Other identifiers 1

IdentifierTypeStateIssuer
01739380MedicaidNY

National Provider Directory

National Provider Directory

Locations

1873 Western Ave
Albany, NY 12203
Phone (518) 690-4420

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356493894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VERNEY DR",
            "address_2": "CROTCHED MOUNTAIN FOUNDATION",
            "city": "GREENFIELD",
            "state": "NH",
            "postal_code": "030475000",
            "telephone_number": "603-547-3311",
            "fax_number": "603-547-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035028",
            "telephone_number": "518-452-1214",
            "fax_number": "518-452-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROTCHED MOUNTAIN COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHUMWAY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "603-547-3311"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01739380",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.