NPIMap

Organization Active NPI

Cornerstone Family Healthcare

  • Federally Qualified Health Center (FQHC)
  • New City, NY
National Provider Identifier
1740803535
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CORNERSTONE FAMILY HEALTHCARE
Practice address
260 N Little Tor Rd
New City, NY 10956-2627
Phone
(845) 999-3060
NPI assigned
May 27, 2020
Last updated
Jul 3, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CORNERSTONE FAMILY HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Authorized official

Name
David Jolly
Title
Ceo
Phone
(845) 220-3165

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Hearing Aid Equipment 332S00000X NU

Addresses

Primary practice location

260 N Little Tor Rd
New City, NY 10956-2627

Mailing address

2570 Route 9W Ste 10
Cornwall, NY 12518-1370
Phone (845) 220-3100

Other names 1

  • The Greater Hudson Valley Family Health Center, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171102001433 NY Part A Provider - Federally Qualified Health Center (FQHC) 4880610393 1 other NPI on this enrollment
Practice locations: New City, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740803535. Details of each certification follow.

Federally qualified health center certification: CCN 571085

Legal name
CORNERSTONE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 28, 2017
Last certification
Nov 28, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 6, 1981 in NY
Enrollment address
260 N Little Tor Rd
New City, NY 10956-2627

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Karin H Miller11 organizations share this tax ID, including this one
Part of
Karin H Miller

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Patricia Claiborne Individual Corporate OfficerBoard Member Jul 1, 2018
Michele McKeon Individual Corporate OfficerBoard Member Apr 26, 2022
Nelson McAllister Individual Corporate OfficerBoard Member Jan 1, 2002
Andrew Bell Individual Corporate OfficerBoard Member Apr 27, 2021
Wayne Day Individual Corporate OfficerBoard Member Jan 1, 2008
Debra Johnson Individual Corporate OfficerBoard Member Jan 1, 2008
Jason T Giordano Individual Corporate OfficerBoard Member Jul 26, 2022
Andrew Sherman Evans Individual Corporate OfficerBoard Member Apr 27, 2021
Rhonda Green Individual Corporate OfficerBoard Member Apr 1, 2019
Charles a Walwyn Individual Corporate OfficerBoard Member Apr 25, 2017
Daisy Vale Individual Corporate OfficerBoard Member Apr 1, 2007
Cheryl Ross Individual Corporate OfficerBoard Member Nov 1, 2018
David Jolly Individual Corporate OfficerCeo/President Jan 6, 2023
W-2 Managing EmployeeCeo/President Jan 6, 2023
Aretha Thompson Individual Corporate OfficerBoard Member Apr 27, 2021
Marlene Medina Individual Corporate OfficerBoard Member Mar 1, 2015
Daniel Lamb Individual Corporate OfficerBoard Member Apr 25, 2017
Eric Gatsik Individual Corporate OfficerBoard Member Jan 1, 2015
Amy Ansehl Individual Corporate OfficerBoard Member Apr 27, 2021
Paul Ernenwein Individual Corporate OfficerBoard Member Jan 1, 2014
Inaudy Esposito Individual Corporate OfficerBoard Member Jan 25, 2022

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1740803535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROUTE 9W STE 10",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181370",
            "telephone_number": "845-220-3100",
            "fax_number": "845-534-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 N LITTLE TOR RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562627",
            "telephone_number": "845-999-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORNERSTONE FAMILY HEALTHCARE",
        "enumeration_date": "2020-05-27",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "JOLLY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "845-220-3165"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Greater Hudson Valley Family Health Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Greater Hudson Valley Family Health Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.