NPIMap

Organization Active NPI

Gouverneur Hospital

  • Rural Health Clinic/Center
  • Gouverneur, NY
National Provider Identifier
1508581901
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GOUVERNEUR HOSPITAL
Practice address
8 Church St
Gouverneur, NY 13642-1416
Phone
(315) 287-1000
NPI assigned
Oct 7, 2022
Last updated
Oct 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Kelly J Cicchinelli
Title
Cfo
Phone
(315) 261-5102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

8 Church St
Gouverneur, NY 13642-1416

Mailing address

77 W Barney St
Gouverneur, NY 13642-1040

National Provider Directory

National Provider Directory
Tax ID family
Gouverneur Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

8 Church St
Gouverneur, NY 13642
Phone (315) 287-1000

NPI Registry JSON

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1508581901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CHURCH ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421416",
            "telephone_number": "315-287-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOUVERNEUR HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "CICCHINELLI",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-261-5102"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gouverneur, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.