Columbia Memorial Regional Medical PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

COLUMBIA MEMORIAL REGIONAL MEDICAL PLLC

Practice address

6171 Route 23a
Tannersville, NY 12485

Phone

(518) 589-6843

Fax

(518) 589-6844

NPI assigned

Feb 15, 2021

Organization subpart

No

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

Authorized official

Name

Bryan T. Mahoney

Title

Chief Financial Officer

Phone

(518) 828-8090

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tannersville Family Care Other name

Tax ID family

CMH Rapid Care- Catskill4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Columbia Memorial Regional Medical PLLC

  • Multi-Specialty Clinic/Center
  • Coxsackie, NY
  • NPI 1417540824
  NPD tax ID
• Columbia Memorial Regional Medical PLLC

  • Multi-Specialty Clinic/Center
  • Cairo, NY
  • NPI 1518550037
  NPD tax ID
• Columbia Memorial Regional Medical PLLC

  • Multi-Specialty Clinic/Center
  • Catskill, NY
  • NPI 1689267288
  NPD tax ID

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1679166284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342000",
            "telephone_number": "518-697-3258",
            "fax_number": "518-828-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6171 ROUTE 23A",
            "city": "TANNERSVILLE",
            "state": "NY",
            "postal_code": "12485",
            "telephone_number": "518-589-6843",
            "fax_number": "518-589-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MEMORIAL REGIONAL MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-15",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "518-828-8090"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03227290",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tannersville Family Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Courtney Brady, DPT
• Dr Mark Haltrecht PLLC
• Grove Street Chiropractic, PC
• Hunter Tannersville Central School
• Alison M Hyer
• Barbara R Lacitignola, AEMT

• Multi-Specialty Clinic/Center in Tannersville, NY
• Providers in Tannersville, NY by specialty
• Multi-Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.