NPIMap

Organization Active NPI

Whitney M. Young, Jr. Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albany, NY
National Provider Identifier
1689947756
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
0101205R Issued in NY
Legal business name
WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.
Practice address
676 Clinton Ave
Albany, NY 12206-2216
Phone
(518) 475-5723
NPI assigned
Feb 20, 2012
Organization subpart
Yes
Parent organization
WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Authorized official

Name
David Harold Shippee
Title
President & Ceo
Phone
(518) 591-4459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 0101205R NY Primary

Addresses

Primary practice location

676 Clinton Ave
Albany, NY 12206-2216

Mailing address

920 Lark Dr
Albany, NY 12207-1300

Other practice location 1

920 Lark Drive
Whitney M. Young Jr. Health Center
Albany, NY 12207
Phone (518) 465-4771 ext. 4454

Other identifiers 1

IdentifierTypeStateIssuer
00473565MedicaidNY

Other names 1

  • Schuyler Achievement Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 571145

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
WHITNEY M YOUNG JR HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 26, 2018
Last certification
Dec 26, 2018
Ownership / control type
For profit – corporation
Facility address
676 Clinton Ave
Albany, NY 12206

National Provider Directory

National Provider Directory
Part of
Whitney M Young Troy Health

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1689947756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 LARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122071300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 CLINTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122062216",
            "telephone_number": "518-475-5723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Lark Drive",
            "address_2": "Whitney M. Young Jr. Health Center",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12207",
            "country_code": "US",
            "telephone_number": "518-465-4771 x4454",
            "fax_number": "518-242-4770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.",
        "enumeration_date": "2012-02-20",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "SHIPPEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "518-591-4459"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "0101205R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473565",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schuyler Achievement Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.