NPIMap

Organization Active NPI

Columbia Memorial Hospital

Doing business as Chatham & Ghent Family Care Center

  • Rural Health Clinic/Center
  • Chatham, NY
National Provider Identifier
1508751132
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COLUMBIA MEMORIAL HOSPITAL
Doing business as
Chatham & Ghent Family Care Center
Practice address
31 Dardess Dr
Chatham, NY 12037-1438
Phone
(518) 392-6650
NPI assigned
Jun 12, 2025
Last updated
Jul 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Authorized official

Name
Bryan T Mahoney
Title
Cfo
Phone
(518) 828-8090

Specialties & licenses 1

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

Addresses

Primary practice location

31 Dardess Dr
Chatham, NY 12037-1438

Mailing address

PO Box 2000
Hudson, NY 12534-2000
Phone (518) 828-8051

Other names 1

  • Chatham & Ghent Family Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250819000804 NY Part A Provider - Rural Health Clinic 5092709410 Practice locations: Chatham, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508751132. Details of each certification follow.

Rural health clinic certification: CCN 333426

Legal name
COLUMBIA MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 28, 2025
Last certification
Dec 28, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
31 Dardess Dr
Chatham, NY 12037-1438
Related CCNs
330094

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Dilara Z Khandaker65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Bryan T Mahoney Individual Corporate OfficerCfo Apr 1, 2016
W-2 Managing Employee Apr 1, 2016
Operational/Managerial Control Apr 1, 2016
Raimundo C Archibold Individual Corporate DirectorBoard of Director Jun 5, 2024
Dorothy Urschel Individual Corporate OfficerPresident/Ceo Jan 1, 2023
W-2 Managing Employee Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Courtney Haskins Individual Corporate DirectorBoard of Director Jun 5, 2024

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1508751132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342000",
            "telephone_number": "518-828-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 DARDESS DR",
            "city": "CHATHAM",
            "state": "NY",
            "postal_code": "120371438",
            "telephone_number": "518-392-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "518-828-8090"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chatham & Ghent Family Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chatham, NY

Sources for this page

Verify at the official NPI Registry.