NPIMap

Organization Active NPI

Oak Orchard Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Albion, NY
National Provider Identifier
1407453244
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OAK ORCHARD COMMUNITY HEALTH CENTER INC
Practice address
14014 State Route 31
Albion, NY 14411-9301
Phone
(585) 637-3905
NPI assigned
Oct 5, 2020
Last updated
Oct 5, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
OAK ORCHARD COMMUNITY HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Mary Ann Pettibon
Title
Ceo
Phone
(585) 637-3905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

14014 State Route 31
Albion, NY 14411-9301

Mailing address

300 West Ave
Brockport, NY 14420-1118
Phone (585) 637-3905

Other names 1

  • Oak Orchard Community Health Center Inc. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521001124 NY Part B Supplier - Clinic/Group Practice 5496746927 Receives reassigned benefits from 61 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hornell, NY; Warsaw, NY; Medina, NY; Lyndonville, NY; Corfu, NY; Batavia, NY; Albion, NY; Alexander, NY…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Oak Orchard Community Health Center Inc

Locations

14014 State Route 31
Albion, NY 14411
Phone (585) 589-3292

301 West Ave
Albion, NY 14411
Phone (585) 589-5613

20 Elm St
Hornell, NY 14843
Phone (607) 281-1970

36 Genesee St
Hornell, NY 14843
Phone (607) 324-0314

911 W Center St
Medina, NY 14103
Phone (585) 637-3905

Practitioners & affiliated clinicians

Practitioners 70

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.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1407453244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201118",
            "telephone_number": "585-637-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14014 STATE ROUTE 31",
            "city": "ALBION",
            "state": "NY",
            "postal_code": "144119301",
            "telephone_number": "585-637-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK ORCHARD COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAK ORCHARD COMMUNITY HEALTH CENTER INC",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "PETTIBON",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "585-637-3905"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Orchard Community Health Center Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albion, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.

Verify at the official NPI Registry.