NPIMap

Organization Active NPI

Guthrie Ahc

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Drum, NY
National Provider Identifier
1457556136
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
GUTHRIE AHC
Practice address
10205 N Riva Ridge Loop
Suite P10205
Fort Drum, NY 13602-5457
Phone
(315) 772-8891
NPI assigned
Jun 20, 2007
Organization subpart
Yes
Parent organization
GUTHRIE AHCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Authorized official

Name
Nancy Draper
Title
Acting Ubo Manager
Phone
(315) 772-1755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary

Addresses

Primary practice location

10205 N Riva Ridge Loop
Suite P10205
Fort Drum, NY 13602-5457

Mailing address

11050 Mount Belvedere Blvd
Ubo
Fort Drum, NY 13602-5438
Phone (315) 772-4033

Other names 1

  • USADC MARSHALL-DRUM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Guthrie Ahc13 organizations share this tax ID, including this one
Part of
Guthrie Ahc

Other organizations with this tax ID 12

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

Locations

10205 N Riva Ridge Loop
Ste P10205
Fort Drum, NY 13602
Phone (315) 772-8891

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1457556136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "address_2": "UBO",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10205 N RIVA RIDGE LOOP",
            "address_2": "SUITE P10205",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025457",
            "telephone_number": "315-772-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTHRIE AHC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUTHRIE AHC",
        "enumeration_date": "2007-06-20",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "DRAPER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "ACTING UBO MANAGER",
        "authorized_official_telephone_number": "315-772-1755"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USADC MARSHALL-DRUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Drum, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.