Gouverneur Family Health NP

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GOUVERNEUR FAMILY HEALTH NP

Practice address

8 Clark St
Philadelphia, NY 13673-5000

Phone

(315) 804-5753

NPI assigned

Mar 7, 2025

Last updated

Mar 7, 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

Mr. John L Welborn IV, FNPNPI 1427496835

Title

Owner

Phone

(315) 804-5753

Specialties & licenses 1

Addresses

Practitioners 1

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.

• John L Welborn IV, FNP-C

  • Family Nurse Practitioner
  • Gouverneur, NY
  • NPI 1427496835
  NPD Authorized official

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1487452082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CLARK ST",
            "city": "PHILADELPHIA",
            "state": "NY",
            "postal_code": "136735000",
            "telephone_number": "315-804-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CLARK ST",
            "city": "PHILADELPHIA",
            "state": "NY",
            "postal_code": "136735000",
            "telephone_number": "315-804-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOUVERNEUR FAMILY HEALTH NP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "WELBORN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-804-5753",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean M Christman, DMD
• Genesis M Colon
• Elizabeth Megan Czigler, PT
• Shelby J Dwyer-Honeywell
• Valerie Christine Gamble, DPT
• Indian River Ambulance Service Inc
• Indian River Central School District
• Erin Ashley Kiechle, LMHC
• Mirza M Ashraf & Mulazim H Khan (Philadelphia Medical Center)
• Joseph Timothy Shanly, LCSW-R

• Primary Care Clinic/Center in Philadelphia, NY
• Providers in Philadelphia, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.