Faxton St Lukes Healthcare

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

FAXTON ST LUKES HEALTHCARE

Practice address

131 Main St Ste 101
Oneida, NY 13421

Phone

(315) 366-0360

NPI assigned

Sep 26, 2017

Last updated

Jul 12, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

FAXTON ST LUKES HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Cody White

Title

Revenue Cycle Director

Phone

(315) 801-4429

Specialties & licenses 1

Addresses

Electronic endpoints 1

Part of

Faxton St Lukes Ilion

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1760991491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE ST/ BUSINESS OFFICE",
            "address_2": "ROOM #315",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015809",
            "telephone_number": "315-801-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MAIN ST STE 101",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "13421",
            "telephone_number": "315-366-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAXTON ST LUKES HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAXTON ST LUKES HEALTHCARE",
        "enumeration_date": "2017-09-26",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "315-801-4429"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Grace Evans, PHARM D
• Family Support in Central New York, Inc.
• Tammy Farr, FNP-BC
• Regina Farrell, MD
• Faxton St Lukes Healthcare
• Anita Fellows, LCSW
• Alyssa Fernandez, MSW
• Cassandra Casabonne Fisher
• Peter Daniel Fleming, PA-C
• Krislyn Leigh Flint, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oneida, NY
• Providers in Oneida, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.