NPIMap

Organization Active NPI

Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
National Provider Identifier
1467526889
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHENANGO MEMORIAL HOSPITAL, INC.
Practice address
179 N Broad St
Norwich, NY 13815-1019
Phone
(607) 337-4111
Fax
(607) 337-4293
NPI assigned
Nov 17, 2006
Last updated
Jan 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Dr. Drake Lamen, M.D.NPI 1356488712
Title
President & Ceo
Phone
(607) 337-4113

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 15

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

179 N Broad St
Norwich, NY 13815-1019

Mailing address

179 N Broad St
Norwich, NY 13815-1019
Phone (607) 337-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040225000911 NY Part B Supplier - Clinic/Group Practice 7517853633 Receives reassigned benefits from 216 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norwich, NY; Oxford, NY; Sherburne, NY; Sidney, NY; Syracuse, NY; Vestal, NY; Baldwinsville, NY; Apalachin, NY…
O20070212000527 NY Part A Provider - Hospital 7517853633 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sidney, NY; Sherburne, NY; Oxford, NY; Norwich, NY
O20240327003753 PA Part B Supplier - Clinic/Group Practice 7517853633 Receives reassigned benefits from 3 practitioners
Practice locations: Baden, PA; Moosic, PA; South Abington Township, PA; Warminster, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467526889. Details of each certification follow.

Hospital certification: CCN 330033

Legal name
CHENANGO MEMORIAL HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 9, 2025
Beds
58
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 29, 1910 in NY
Enrollment address
179N Broad St
Norwich, NY 13815-1019
Other Hospital Practice Location
Hospital subgroups
General

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Chenango Memorial HospitalCCN 330033 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

33 Lewis Rd
Ste 2
Binghamton, NY 13905

558 Larkfield Rd
East Northport, NY 11731
Phone (631) 446-7459

38 Classic St
Sherburne, NY 13460

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Kurt R Harding Individual Corporate Director Jun 3, 2024
Eric Larsen Individual Corporate DirectorBoard Member Jun 1, 2015
Rohan S Jayasena Individual Corporate Director Aug 4, 2025
James Mark Smith Individual Corporate Director Jan 1, 2022
Shaunastar Hyle Individual Corporate Director Jan 1, 2022
John M Carrigg Individual Corporate DirectorBoard Member Jun 1, 2015
Barbara Schindler Individual Corporate Director Apr 1, 2024
Cecil M Miller Individual Contracted Managing Employee Apr 21, 2025
Corporate Director Apr 21, 2025
Joseph R Stagliano Individual Corporate DirectorBoard Member Jun 4, 2019
Elizabeth K Boland Individual Corporate DirectorBoard Member Jan 1, 2018
Julianne a. Oehlbeck Individual Corporate DirectorBoard Member Jun 4, 2019
Bruce Erath Individual Corporate DirectorBoard Member Jun 1, 2015
Luke Hess-Murphy Individual Corporate Director Jun 5, 2023
Robert Nassar Individual Corporate DirectorBoard Member Jun 1, 2015
Martin C Masarech Individual Corporate DirectorBoard Member Jun 4, 2019

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 427

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.

View all 427

Affiliated clinicians 329

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

View all 329

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1467526889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 N BROAD ST",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151019",
            "telephone_number": "607-337-4111",
            "fax_number": "607-337-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 N BROAD ST",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151019",
            "telephone_number": "607-337-4111",
            "fax_number": "607-337-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENANGO MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "LAMEN",
        "authorized_official_first_name": "DRAKE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "607-337-4113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

Verify at the official NPI Registry.