United Cerebral Palsy Association of the North Country, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY, INC.

Doing business as

Community Health Center of the North Country

Practice address

4 Commerce LN
Canton, NY 13617-3739

Phone

(315) 386-1156

Fax

(315) 379-9388

NPI assigned

Jan 20, 2006

Last updated

Jan 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alexander Bryden

Title

Chief Financial Officer

Phone

(315) 379-8320

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Community Health Center of the North Country Doing business as

Medicare fee-for-service enrollment

Enrolled in NY5 enrollments

Enrollment records 5

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1467432765. Details of each certification follow.

• CCN 331979 Federally qualified health center · Active · Details
• CCN 331981 Federally qualified health center · Active · Details
• CCN 331085 Federally qualified health center · Active · Details
• CCN 571195 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 331979

Legal name

UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY INC

Doing business as

COMMUNITY HEALTH CENTER OF THE NORTH COUNTRY.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 31, 2008

Last certification

Mar 31, 2008

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 15, 1999 in NY

Enrollment address

380 County Route 51
Malone, NY 12953-4504

Federally qualified health center certification: CCN 331981

Legal name

UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY INC

Doing business as

COMMUNITY HEALTH CENTER OF THE NORTH COUNTRY

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 21, 2008

Last certification

May 21, 2008

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 15, 1999 in NY

Enrollment address

4 Commerce LN
Canton, NY 13617-3739

Federally qualified health center certification: CCN 331085

Legal name

UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY INC

Doing business as

COMMUNITY HEALTH CENTER OF THE NORTH COUNTRY

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 11, 2013

Last certification

Nov 11, 2013

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

77W Barney St
Gouverneur, NY 13642-1040

Federally qualified health center certification: CCN 571195

Legal name

UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY INC

Doing business as

COMMUNITY HEALTH CENTER OF THE NORTH COUNTRY

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 16, 2020

Last certification

Jan 16, 2020

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 15, 1999 in NY

Enrollment address

102 Ford St
Ogdensburg, NY 13669-1402

Locations

All disclosed owners & managing parties 26

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

Owners & managing parties with NPI records 2

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

• Emma Brackett, LCSW

  • Clinical Social Worker
  • Potsdam, NY
  • NPI 1558719211

  Corporate Director

  CMS ownership
• Andrew Fox Williams, MD

  • Internal Medicine Physician
  • Canton, NY
  • NPI 1154365286

  Corporate Officer

  CMS ownership

Practitioners 51

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.

• Marta M Anghel, MD

  • Internal Medicine Physician
  • Ogdensburg, NY
  • NPI 1891855730
  Medicare reassignment Care Compare group NPD
• Melissa J Benardot, CPNP

  • Family Nurse Practitioner
  • Malone, NY
  • NPI 1427303353
  Medicare reassignment Care Compare group NPD
• Anne Carroll Bender, LCSW

  • Clinical Social Worker
  • Massena, NY
  • NPI 1891828679
  Medicare reassignment Care Compare group NPD
• Nicole Lynne Bonno, RN

  • Family Nurse Practitioner
  • Gouverneur, NY
  • NPI 1154195667

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Melinda D Burwell, PT

  • Specialist
  • Canton, NY
  • NPI 1689841447
  Medicare reassignment Care Compare group NPD
• Ernie S Cougler, NP

  • Family Nurse Practitioner
  • Lisbon, NY
  • NPI 1639514565
  Medicare reassignment Care Compare group NPD
• Amanda L Creel, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, NY
  • NPI 1023546843
  Medicare reassignment Care Compare group NPD
• Sara Elliott

  • Clinical Social Worker
  • Canton, NY
  • NPI 1922793447
  Medicare reassignment Care Compare group NPD
• Alyson Felt, FNP-C

  • Family Nurse Practitioner
  • Cobleskill, NY
  • NPI 1801134820
  Medicare reassignment Care Compare group NPD
• Derek Fenton

  • Family Nurse Practitioner
  • Ogdensburg, NY
  • NPI 1245923424
  Medicare reassignment Care Compare group NPD
• Emily Frank

  • Family Nurse Practitioner
  • Malone, NY
  • NPI 1063056455
  Medicare reassignment Care Compare group NPD
• Valerie Christine Gamble, DPT

  • Physical Therapist
  • Philadelphia, NY
  • NPI 1396178018
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1467432765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COMMERCE LN",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173739",
            "telephone_number": "315-386-1156",
            "fax_number": "315-379-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COMMERCE LN",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173739",
            "telephone_number": "315-386-1156",
            "fax_number": "315-379-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "BRYDEN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "315-379-8320"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01995615",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of the North Country",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tree of Life Midwifery
• Isreal Tyler
• United Cerebral Palsy Assoc of the North Country Inc (Cerebral Palsy Association of the North Country Inc)
• United Cerebral Palsy Association of the North Country
• United Cerebral Palsy Association of the North Country Inc (Cerebral Palsy Association of the North Country)
• United Helpers Canton Nursing Home, Inc (Maplewood Assisted Living)
• United Helpers Canton Nursing Home, Inc (Maplewood Health Care And Rehabilitation Center)
• United Helpers Canton Nursing Home, Inc (United Helpers Rehabilitation and Senior Care)
• United Helpers Residence Inc
• Nicholas Matthew Usuriello, ATC

• Federally Qualified Health Center (FQHC) in Canton, NY
• Providers in Canton, NY by specialty
• 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 22, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.