NPIMap

Organization Active NPI

Herkimer County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Herkimer, NY
National Provider Identifier
1720174436
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
6690100A Issued in NY
Legal business name
HERKIMER COUNTY
Practice address
301 N Washington St Ste 2470
Herkimer, NY 13350-1299
Phone
(315) 867-1465
Fax
(315) 867-1469
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Mr. Edgar Rogers Scudder, LCSW
Title
Director of Community Services
Phone
(315) 867-1465

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 6690100A NY Primary
Adult Mental Health Clinic/Center 261QM0850X 6690100A NY

Addresses

Primary practice location

301 N Washington St Ste 2470
Herkimer, NY 13350-1299

Mailing address

301 N Washington St Ste 2470
Herkimer, NY 13350-1299
Phone (315) 867-1465

Other identifiers 1

IdentifierTypeStateIssuer
00657658MedicaidNY

Other names 1

  • Herkimer County Mental Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071108000118 NY Part B Supplier - Clinic/Group Practice 4284613779 Receives reassigned benefits from 12 practitioners
Practice locations: Herkimer, NY

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Early Intervention Program7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

301 N Washington St
Ste 2470
Herkimer, NY 13350
Phone (315) 867-1465

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1720174436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N WASHINGTON ST STE 2470",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133501299",
            "telephone_number": "315-867-1465",
            "fax_number": "315-867-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N WASHINGTON ST STE 2470",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133501299",
            "telephone_number": "315-867-1465",
            "fax_number": "315-867-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERKIMER COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "SCUDDER",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "ROGERS",
        "authorized_official_title_or_position": "DIRECTOR OF COMMUNITY SERVICES",
        "authorized_official_telephone_number": "315-867-1465",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "6690100A",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "6690100A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00657658",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Herkimer County Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Herkimer, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.