Organization Active NPI

Fort Hudson Nursing Center, Inc.

  • Skilled Nursing Facility
  • Fort Edward, NY
National Provider Identifier
1417947722
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5724302N Issued in NY
Legal business name
FORT HUDSON NURSING CENTER, INC.
Practice address
319 Broadway
Fort Edward, NY 12828-1221
Phone
(518) 747-2811
Fax
(518) 747-2740
NPI assigned
Oct 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Mr. Andrew A. Cruikshank, RN, LNHA
Title
Ceo/Administrator
Phone
(518) 747-2811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5724302N NY Primary

Addresses

Primary practice location

319 Broadway
Fort Edward, NY 12828-1221

Mailing address

319 Broadway
Fort Edward, NY 12828-1221
Phone (518) 747-2811

Other identifiers 3

IdentifierTypeStateIssuer
5724302NOtherNYOPERATING CERTIFICATE
01380249MedicaidNY
00313557MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000672 NY Part A Provider - Skilled Nursing Facility 9931007242 Practice locations: Fort Edward, NY

Skilled nursing facility certification: CCN 335300

Legal name
FORT HUDSON NURSING CENTER INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 12, 1970
Last certification
Dec 6, 2024
Beds
196
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 17, 2003 in NY
Enrollment address
319 Broadway
Fort Edward, NY 12828-1221
Nursing home name
FORT HUDSON NURSING CENTER INC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fort Hudson Nursing Center IncCCN 335300
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 12, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
196184.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Fort Hudson Nursing Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Glens Falls National Bank and Trust Company Organization, Glens Falls, NY Financial institution 5% Or Greater Mortgage Interest Jul 11, 2024 5%
Andrew a Cruikshank Individual Corporate OfficerCeo Feb 28, 2000
W-2 Managing EmployeeCeo Feb 28, 2000 100%
Philip J Gara Individual Contracted Managing EmployeeMD; Jul 1, 2004 75%
Adp of the SNF Dec 9, 2024
John W Coburn Individual Corporate OfficerCfo Apr 26, 2000
W-2 Managing EmployeeCfo Apr 26, 2000 100%
Amanda Ann Waite Individual W-2 Managing EmployeeAd; Apr 7, 2014 100%
Adp of the SNF Dec 9, 2024
Fort Hudson Health System, Inc. Organization, Fort Edward, NY Created for acquisition, Corporation, Non-profit Other Jul 1, 2004 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1417947722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 BROADWAY",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281221",
            "telephone_number": "518-747-2811",
            "fax_number": "518-747-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 BROADWAY",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281221",
            "telephone_number": "518-747-2811",
            "fax_number": "518-747-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT HUDSON NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "CRUIKSHANK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "518-747-2811",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5724302N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING CERTIFICATE",
            "identifier": "5724302N",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01380249",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00313557",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Edward, NY

Sources for this page

Verify at the official NPI Registry.