Organization Active NPI

Clifton Springs Medical Service PLLC

  • Internal Medicine Physician
  • Clifton Springs, NY
National Provider Identifier
1467592014
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CLIFTON SPRINGS MEDICAL SERVICE PLLC
Practice address
4 Coulter Rd
Clifton Springs, NY 14432-1122
Phone
(315) 462-2633
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Chester Nakamura, MD
Title
President
Phone
(315) 462-2633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4 Coulter Rd
Clifton Springs, NY 14432-1122

Mailing address

4 Coulter Rd
Clifton Springs, NY 14432-1122

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467592014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-462-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON SPRINGS MEDICAL SERVICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAKAMURA",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-462-2633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.