Active NPI
State of New York
- Intellectual Disabilities Intermediate Care Facility
- Schenectady, NY
National Provider Identifier
1750420501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- OMRDD236
- Legal business name
- STATE OF NEW YORK
- Practice address
- Balltown & Consaul RDS
Schenectady, NY 12304 - Phone
- (518) 402-4333
- NPI assigned
- Feb 6, 2007
- Last updated
- Jun 25, 2008
- Organization subpart
- Yes
- Parent organization
- STATE OF NEW YORK
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karla Smith
- Title
- Director of Central Operations
- Phone
- (518) 402-4333
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | OMRDD236 | NY | Primary |
Addresses
Primary practice location
Balltown & Consaul RDS
Schenectady, NY 12304
Mailing address
44 Holland Ave
5TH Floor Central Operations
Albany, NY 12229-0001
Phone (518) 402-4333
Other names 1
- OD Heck Developmental Center
National Provider Directory
National Provider Directory- Tax ID family
- Monroe Ddso Clinic University
- Part of
- Monroe Ddso Clinic University
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214352000000",
"number": "1750420501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 HOLLAND AVE",
"address_2": "5TH FLOOR CENTRAL OPERATIONS",
"city": "ALBANY",
"state": "NY",
"postal_code": "122290001",
"telephone_number": "518-402-4333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BALLTOWN & CONSAUL RDS",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "12304",
"telephone_number": "518-402-4333"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE OF NEW YORK",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "STATE OF NEW YORK",
"enumeration_date": "2007-02-06",
"last_updated": "2008-06-25",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "KARLA",
"authorized_official_title_or_position": "DIRECTOR OF CENTRAL OPERATIONS",
"authorized_official_telephone_number": "518-402-4333"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "NY",
"license": "OMRDD236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "OD Heck Developmental Center",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Schenectady, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.