Active NPI
Inter-Community Memorial Hospital of Newfane, Inc.
- General Acute Care Hospital
- Newfane, NY
National Provider Identifier
1639167190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 3154000H
- Legal business name
- INTER-COMMUNITY MEMORIAL HOSPITAL OF NEWFANE, INC.
- Practice address
- 2600 William St
Newfane, NY 14108-1026 - Phone
- (716) 778-5111
- Fax
- (716) 778-0256
- NPI assigned
- Oct 10, 2005
- Last updated
- Mar 18, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Donald L Kepner
- Title
- Chief Financial Officer
- Phone
- (716) 778-5111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 3154000H | NY | Primary |
Addresses
Primary practice location
2600 William St
Newfane, NY 14108-1026
Mailing address
2600 William St
Newfane, NY 14108-1026
Phone (716) 778-5111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00011412401 | Other | NY | UNIVERA BILLING # |
| 09 | Other | NY | IHA BILLING # |
| 00354325 | Medicaid | NY | |
| 50 | Other | NY | BCBS BILLING # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1639167190. Details of each certification follow.
Hospital certification: CCN 330025
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- INTER-COMMUNITY MEMORIAL HOSPITAL AT NEWFANE, INC.
- Certification status
- Terminated Voluntary: merger or closure, Feb 1, 2009
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- May 25, 2007
- Beds
- 71
- Ownership / control type
- Private (not for profit)
- Facility address
- 2600 William Street
Newfane, NY 14108
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205798400000",
"number": "1639167190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 WILLIAM ST",
"city": "NEWFANE",
"state": "NY",
"postal_code": "141081026",
"telephone_number": "716-778-5111",
"fax_number": "716-778-0256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 WILLIAM ST",
"city": "NEWFANE",
"state": "NY",
"postal_code": "141081026",
"telephone_number": "716-778-5111",
"fax_number": "716-778-0256"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTER-COMMUNITY MEMORIAL HOSPITAL OF NEWFANE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-10",
"last_updated": "2008-03-18",
"status": "A",
"authorized_official_last_name": "KEPNER",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "716-778-5111",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "NY",
"license": "3154000H",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA BILLING #",
"identifier": "00011412401",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA BILLING #",
"identifier": "09",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00354325",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS BILLING #",
"identifier": "50",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newfane, NY
- Farzana Habib (Newfane OB-GYN)
- Michael A Gray, RPA-C
- Lubna Syed Guru, MD
- Harnath Clerk MD PC
- Integrated Care Systems, LLC (Newfane Rehabilitation & Health Care Center)
- Kourtney Gerstung SLP PLLC
- Kellsie Jean Lamb, M.A.
- M. Ashraf Sahaf, Physician , P.C.
- Miller Hose Company, Inc.
- Samaneh Mohammad Bagher Zadeh Torbati
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.