Family Health Network of Central New York, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC

Practice address

711 Railroad St
De Ruyter, NY 13052-9700

Phone

(315) 852-3400

Fax

(607) 662-4916

NPI assigned

Jan 19, 2022

Organization subpart

Yes

Parent organization

FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INCAs reported in NPPES

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

Authorized official

Name

Kimberly Osborne

Title

Ceo

Phone

(607) 753-3797

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SBHC-DeRuyter Central School Doing business as

Part of

Family Health Netwk of

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Family Health Network of Central New York, Inc.

  • Federally Qualified Health Center (FQHC)
  • Homer, NY
  • NPI 1043374853
  NPPES parent name

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1407508708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 S WEST ST",
            "city": "HOMER",
            "state": "NY",
            "postal_code": "130771542",
            "telephone_number": "607-753-3797",
            "fax_number": "607-753-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 RAILROAD ST",
            "city": "DE RUYTER",
            "state": "NY",
            "postal_code": "130529700",
            "telephone_number": "315-852-3400",
            "fax_number": "607-662-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "607-753-3797"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474144",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SBHC-DeRuyter Central School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Blythe Degear, PT
• Deruyter Central School
• Alysia Irene Gallerani
• Sandra Louise Hathaway, RN
• Jamie Mody, M.A., CCC-SLP
• Deborah Warner, NP

• All providers in De Ruyter, NY
• Federally Qualified Health Center (FQHC) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.