NPIMap

Organization Active NPI

Chautauqua County Chapter of Nysarc Inc.

  • Developmental Disabilities Clinic/Center
  • Jamestown, NY
National Provider Identifier
1811050214
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
6069-160 Issued in NY
Legal business name
CHAUTAUQUA COUNTY CHAPTER OF NYSARC INC.
Practice address
75 Jones and Gifford Ave
Jamestown, NY 14701-2828
Phone
(716) 661-1400
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Authorized official

Name
Denise Jones
Title
Executive Director
Phone
(716) 661-1412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X 6069-160 NY Primary

Addresses

Primary practice location

75 Jones and Gifford Ave
Jamestown, NY 14701-2828

Mailing address

200 Dunham Ave
Jamestown, NY 14701-2528
Phone (716) 661-1400

Other identifiers 2

IdentifierTypeStateIssuer
J100184027OtherNYMEDICARE PTAN
03004928MedicaidNY

Other names 1

  • The Resource Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150106000023 NY Part B Supplier - Clinic/Group Practice 9234452947 Receives reassigned benefits from 31 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dunkirk, NY; Fredonia, NY; Jamestown, NY

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Chautauqua County Chapter of Nysarc Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

890 E 2nd St
Jamestown, NY 14701
Phone (716) 661-1447

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1811050214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DUNHAM AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012528",
            "telephone_number": "716-661-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JONES AND GIFFORD AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012828",
            "telephone_number": "716-661-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAUTAUQUA COUNTY CHAPTER OF NYSARC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "716-661-1412"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NY",
            "license": "6069-160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J100184027",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03004928",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Resource Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.