NPIMap

Organization Active NPI

Family Practice Associates, P.C

  • Family Medicine Physician
  • Carthage, NY
National Provider Identifier
1669514592
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY PRACTICE ASSOCIATES, P.C
Practice address
40 Franklin Street
Suite 1
Carthage, NY 13619-1323
Phone
(315) 493-7334
Fax
(315) 493-4232
NPI assigned
Feb 14, 2007
Last updated
Nov 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Authorized official

Name
Dr. Kenneth J Fish, DONPI 1912972423
Title
Owner
Phone
(315) 493-7334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

40 Franklin Street
Suite 1
Carthage, NY 13619-1323

Mailing address

40 Franklin Street
Suite 1
Carthage, NY 13619-1323
Phone (315) 493-7334

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000971 NY Part B Supplier - Clinic/Group Practice 5890684500 Receives reassigned benefits from 9 practitioners
Practice locations: Carthage, NY; Watertown, NY

National Provider Directory

National Provider Directory

Locations

40 Franklin St
Ste 1
Carthage, NY 13619
Phone (315) 493-7334

1116 Arsenal St
Ste 501
Watertown, NY 13601
Phone (315) 786-1111

Practitioners & affiliated clinicians

Practitioners 9

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": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1669514592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FRANKLIN STREET",
            "address_2": "SUITE 1",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191323",
            "telephone_number": "315-493-7334",
            "fax_number": "315-493-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 FRANKLIN STREET",
            "address_2": "SUITE 1",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191323",
            "telephone_number": "315-493-7334",
            "fax_number": "315-493-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE ASSOCIATES, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-493-7334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.