NPIMap

Organization Active NPI

Madison County

  • Public Health or Welfare Agency
  • Wampsville, NY
National Provider Identifier
1487796975
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
MADISON COUNTY
Practice address
138 North Court St
Building 5
Wampsville, NY 13163-0605
Phone
(315) 366-2501
Fax
(315) 366-2207
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Authorized official

Name
Mr. Eric Faisst
Title
Public Health Director
Phone
(315) 366-2501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

138 North Court St
Building 5
Wampsville, NY 13163-0605

Mailing address

PO Box 605
Wampsville, NY 13163-0605
Phone (315) 366-2501

Other identifiers 1

IdentifierTypeStateIssuer
00474153MedicaidNY

Other names 1

  • Madison County Department of Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120319000307 NY Part B Supplier - Mass Immunization (Roster Biller Only) 2365335957 Practice locations: Wampsville, NY

Other NPIs with the same Medicare PAC ID 1

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

  • Madison County
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Wampsville, NY
    • NPI 1689780546

    2365335957

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Madison County10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

138 N Court St
Bldg 5
Wampsville, NY 13163
Phone (315) 366-2361

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1487796975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 605",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131630605",
            "telephone_number": "315-366-2501",
            "fax_number": "315-366-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 NORTH COURT ST",
            "address_2": "BUILDING 5",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131630605",
            "telephone_number": "315-366-2501",
            "fax_number": "315-366-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "FAISST",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PUBLIC HEALTH DIRECTOR",
        "authorized_official_telephone_number": "315-366-2501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474153",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison County Department of Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wampsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.