Oak Orchard Community Health Center, Inc.

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

OAK ORCHARD COMMUNITY HEALTH CENTER, INC.

Doing business as

Lakeside Women's Health

Practice address

156 West Ave
Suite 104
Brockport, NY 14420-1229

Phone

(585) 637-6040

NPI assigned

Aug 24, 2007

Last updated

Mar 14, 2008By 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. David W. Fisher

Title

Ceo

Phone

(585) 637-3905

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Lakeside Women's Health Doing business as

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1548453368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201118",
            "telephone_number": "585-637-3905",
            "fax_number": "585-637-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 WEST AVE",
            "address_2": "SUITE 104",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201229",
            "telephone_number": "585-637-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK ORCHARD COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "585-637-3905",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Migrant Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355308",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Esther Nowak, PT
• Wendy Nupp, RDH
• Oak Orchard Community Health Center (Oak Orchard OBGYN)
• Oak Orchard Community Health Center Inc. (Oak Orchard Health)
• Oak Orchard Community Health Center, Inc. (Oak Orchard Health Pharmacy)
• Oak Orchard Community Health Center, Inc.
• Thomas H. Ophardt, O.D.
• Michael Paganin, RPH
• Emily Marie Pawlowski, PT
• Chase Abbott Pecoraro, DPT

• Community Health Clinic/Center in Brockport, NY
• Providers in Brockport, NY by specialty
• Community Health Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.