NPIMap

Organization Active NPI

Scottsville Family Medicine, LLC

  • Family Medicine Physician
  • Scottsville, NY
National Provider Identifier
1679978647
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SCOTTSVILLE FAMILY MEDICINE, LLC
Practice address
32B Main Street
Scottsville, NY 14546-1353
Phone
(585) 571-4868
Fax
(585) 348-2100
NPI assigned
Nov 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Johanna Nieboer
Title
Billing Coordinator
Phone
(585) 594-5995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X NY Primary

Addresses

Primary practice location

32B Main Street
Scottsville, NY 14546-1353

Mailing address

P O Box 45
32B Main Street
Scottsville, NY 14546-1353
Phone (585) 571-4868

National Provider Directory

National Provider Directory

Locations

32 Main St
Ste B
Scottsville, NY 14546
Phone (585) 571-4868

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1679978647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 45",
            "address_2": "32B MAIN STREET",
            "city": "SCOTTSVILLE",
            "state": "NY",
            "postal_code": "145461353",
            "telephone_number": "585-571-4868",
            "fax_number": "585-348-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32B MAIN STREET",
            "city": "SCOTTSVILLE",
            "state": "NY",
            "postal_code": "145461353",
            "telephone_number": "585-571-4868",
            "fax_number": "585-348-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSVILLE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "NIEBOER",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "585-594-5995"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; 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.