Leatherstocking Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1254301N Issued in NY

Legal business name

LEATHERSTOCKING HEALTHCARE LLC

Doing business as

Countryside Care Center

Practice address

41861 State Highway 10
Delhi, NY 13753-3203

Phone

(315) 219-5548

Fax

(315) 219-5549

NPI assigned

Dec 18, 2006

Last updated

Apr 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ernest Orts

Title

Owner

Phone

(315) 219-5548

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Countryside Care Center Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard J Brown, DO

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • West Winfield, NY
  • NPI 1295725570
  NPD (past)
• Evelyn M Flannery, NP

  • Nurse Practitioner
  • Oneonta, NY
  • NPI 1881835676
  NPD (past)
• Baburao N Samudrala, MD

  • Family Medicine Physician
  • Delhi, NY
  • NPI 1962459008
  NPD (past)
• Om P Wadhera, MD

  • Internal Medicine Physician
  • Herkimer, NY
  • NPI 1538268115
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1801959275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41861 STATE HIGHWAY 10",
            "city": "DELHI",
            "state": "NY",
            "postal_code": "137533203",
            "telephone_number": "315-219-5548",
            "fax_number": "315-219-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41861 STATE HIGHWAY 10",
            "city": "DELHI",
            "state": "NY",
            "postal_code": "137533203",
            "telephone_number": "315-219-5548",
            "fax_number": "315-219-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEATHERSTOCKING HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "ORTS",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-219-5548",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "1254301N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00309128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Countryside Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Lynn Kollig, CCC-SLP
• Dawn Louise Komosinski, LPN
• Ivan Ronald Koota, M.D.
• Victoria Kramp, LAT, ATC
• Jodi L Krzyston, RN
• Amanda Nichole Lewis, M.S., CCC-SLP
• Carol Little, MA
• Rebecca M Little, LPN
• Deborah W Lumia, NPP
• Rebecca Lyon, CCC-SLP

• Skilled Nursing Facility in Delhi, NY
• Providers in Delhi, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.