Active NPI
Fort Hudson Nursing Center, Inc.
- Skilled Nursing Facility
- Fort Edward, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 5724302N
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5724302N | Other | NY | OPERATING CERTIFICATE |
| 01380249 | Medicaid | NY | |
| 00313557 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Inc
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 12, 1970
- Medicare certification status
- Active
- Certified beds
- 196
National Provider Directory
National Provider Directory- Tax ID family
- Fort Hudson Nursing Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Day Care Clinic/Center
- Fort Edward, NY
- NPI 1477639680
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Glens Falls National Bank and Trust Company | 5% Or Greater Mortgage Interest | Jul 11, 2024 | 5% |
| Andrew a Cruikshank | Corporate Officer | Feb 28, 2000 | |
| W-2 Managing Employee | Feb 28, 2000 | 100% | |
| Philip J Gara | Contracted Managing Employee | Jul 1, 2004 | 75% |
| Adp of the SNF | Dec 9, 2024 | ||
| John W Coburn | Corporate Officer | Apr 26, 2000 | |
| W-2 Managing Employee | Apr 26, 2000 | 100% | |
| Amanda Ann Waite | W-2 Managing Employee | Apr 7, 2014 | 100% |
| Adp of the SNF | Dec 9, 2024 | ||
| Fort Hudson Health System, Inc. | 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.
-
- Internal Medicine Physician
- Fort Edward, NY
- NPI 1740278837
Adp of the SNF, Contracted Managing Employee
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Queensbury, NY
- NPI 1710202544
-
- Internal Medicine Physician
- Fort Edward, NY
- NPI 1740278837
-
- Family Medicine Physician
- Gansevoort, NY
- NPI 1750720371
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Fort Edward, NY
- NPI 1740278837
Nursing home
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.