NPIMap

Organization Active NPI

Hamilton County

  • Home Health Agency
  • Indian Lake, NY
National Provider Identifier
1801977376
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
2055601 Issued in NY
Legal business name
HAMILTON COUNTY
Practice address
139 White Birch Lane
Indian Lake, NY 12842-0250
Phone
(518) 648-6141
Fax
(518) 648-6143
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Erica Lynn Tomlinson
Title
Director
Phone
(518) 648-6141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2055601 NY Primary

Addresses

Primary practice location

139 White Birch Lane
Indian Lake, NY 12842-0250

Mailing address

P.O. Box 250
Indian Lake, NY 12842-0250
Phone (518) 648-6141

Other identifiers 1

IdentifierTypeStateIssuer
02997386MedicaidNY

Other names 1

  • Certified Home Health Agency Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100729000846 NY Part A Provider - Home Health Agency 8224160205 Practice locations: Indian Lake, NY

Home health agency certification: CCN 337173

Legal name
HAMILTON COUNTY
Doing business as
HAMILTON COUNTY PUBLIC HEALTH NURSING SERVICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 31, 1978
Last certification
Oct 17, 2018
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Enrollment address
139 White Birch LN
Indian Lake, NY 12842-1422

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hamilton Co Public Health ChhaCCN 337173
Overall star rating
2.5 of 5
Ownership
Government Operated
Certified
Oct 31, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory
Tax ID family
Hamilton County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Erica Lynn Tomlinson Individual W-2 Managing EmployeeDirector Jan 1, 2019 100%
Hamilton County Organization, Indian Lake, NY 5% Or Greater Direct Ownership Interest Jan 1, 2019 100%

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1801977376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 250",
            "city": "INDIAN LAKE",
            "state": "NY",
            "postal_code": "128420250",
            "telephone_number": "518-648-6141",
            "fax_number": "518-648-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 WHITE BIRCH LANE",
            "city": "INDIAN LAKE",
            "state": "NY",
            "postal_code": "128420250",
            "telephone_number": "518-648-6141",
            "fax_number": "518-648-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "TOMLINSON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "518-648-6141"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "2055601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02997386",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Certified Home Health Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indian Lake, NY

Sources for this page

Verify at the official NPI Registry.