Ther Centers at St. Camillus

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

THER CENTERS AT ST. CAMILLUS

Practice address

813 Fay Rd
Syracuse, NY 13219-3009

Phone

(315) 703-0685

Fax

(315) 488-3804

NPI assigned

Nov 26, 2013

Organization subpart

No

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

Authorized official

Name

Octavia Venese Ross-Hardy

Title

Ilst

Phone

(315) 703-0685

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1588094668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 FAY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FAY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193009",
            "telephone_number": "315-703-0685",
            "fax_number": "315-488-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THER CENTERS AT ST. CAMILLUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-26",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "ROSS-HARDY",
        "authorized_official_first_name": "OCTAVIA",
        "authorized_official_middle_name": "VENESE",
        "authorized_official_title_or_position": "ILST",
        "authorized_official_telephone_number": "315-703-0685"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.