NPIMap

Organization Active NPI

Anthony L. Jordan Health Corporation

Doing business as Andrews Terrace

  • Federally Qualified Health Center (FQHC)
  • Rochester, NY
National Provider Identifier
1457626129
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
2701211R Issued in NY
Legal business name
ANTHONY L. JORDAN HEALTH CORPORATION
Doing business as
Andrews Terrace
Practice address
125 Saint Paul St
Rochester, NY 14609
Phone
(585) 325-5232
Fax
(585) 546-3485
NPI assigned
Mar 14, 2012
Last updated
Feb 20, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ANTHONY L. JORDAN HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Janice Harbin, DDSNPI 1467533968
Title
President/Ceo
Phone
(585) 423-2878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 2701211R NY Primary

Addresses

Primary practice location

125 Saint Paul St
Rochester, NY 14609

Mailing address

82 Holland St
Rochester, NY 14605-2131
Phone (585) 423-5800

Other identifiers 5

IdentifierTypeStateIssuer
00384969MedicaidNY
G0187295590OtherNYBLUE CHOICE OF ROCHESTER
6613OtherNYBLUE CROSS OF ROCHESTER
331838OtherNYMEDICARE PART A
16467AOtherNYMEDICARE PART B

Other names 1

  • Andrews Terrace Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040519001335 NY Part B Supplier - Clinic/Group Practice 8729079785 Receives reassigned benefits from 49 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rochester, NY; Canandaigua, NY

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Part of
Anthony L Jordan HLTH C

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1457626129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 HOLLAND ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146052131",
            "telephone_number": "585-423-5800",
            "fax_number": "585-423-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SAINT PAUL ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14609",
            "telephone_number": "585-325-5232",
            "fax_number": "585-546-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY L. JORDAN HEALTH CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANTHONY L. JORDAN HEALTH CORPORATION",
        "enumeration_date": "2012-03-14",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "HARBIN",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "585-423-2878",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "2701211R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00384969",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE OF ROCHESTER",
            "identifier": "G0187295590",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ROCHESTER",
            "identifier": "6613",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART A",
            "identifier": "331838",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "16467A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andrews Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.