NPIMap

Organization Active NPI

Our Lady of Lourdes Memorial Hospital, Inc.

Doing business as Lourdes Center for Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Binghamton, NY
National Provider Identifier
1649947649
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Doing business as
Lourdes Center for Mental Health
Practice address
184 Court St
Binghamton, NY 13901-3515
Phone
(607) 584-4465
NPI assigned
Aug 26, 2021
Last updated
Sep 14, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Authorized official

Name
Natalie Ann Brooksmcmahon
Title
Credentialing Coordinator
Phone
(607) 584-5474

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

184 Court St
Binghamton, NY 13901-3515

Mailing address

169 Riverside Drive
Credentialing Dept @ LBC
Binghamton, NY 13905
Phone (607) 584-5474

Other names 1

  • Lourdes Center for Mental Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211221000340 NY Part B Supplier - Clinic/Group Practice 1254237779 Receives reassigned benefits from 6 practitioners
Practice locations: Binghamton, NY

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Ramanjapu Ramanujan12 organizations share this tax ID, including this one
Part of
Ramanjapu Ramanujan

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1649947649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DRIVE",
            "address_2": "CREDENTIALING DEPT @ LBC",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-584-5474",
            "fax_number": "607-584-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 COURT ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139013515",
            "telephone_number": "607-584-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "BROOKSMCMAHON",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "607-584-5474"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lourdes Center for Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lourdes Center for Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.