Active NPI
Hudson Headwaters Health Network
- Federally Qualified Health Center (FQHC)
- Glens Falls, NY
National Provider Identifier
1811367170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- HUDSON HEADWATERS HEALTH NETWORK
- Practice address
- 118 Broad St
Glens Falls, NY 12801-4348 - Phone
- (518) 792-2223
- Fax
- (518) 636-2077
- NPI assigned
- Sep 30, 2015
- Organization subpart
- Yes
- Parent organization
- HUDSON HEADWATERS HEALTH NETWORK
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christopher Tournier
- Title
- Executive VP of Finance / Cfo
- Phone
- (518) 761-0300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NY | Primary |
Addresses
Primary practice location
118 Broad St
Glens Falls, NY 12801-4348
Mailing address
9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04280466 | Medicaid | NY |
National Provider Directory
National Provider Directory- Part of
- Hudson Headwaters Healt
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443571200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580428800000",
"number": "1811367170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CAREY RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128047880",
"telephone_number": "518-761-0300",
"fax_number": "518-824-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 BROAD ST",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014348",
"telephone_number": "518-792-2223",
"fax_number": "518-636-2077"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUDSON HEADWATERS HEALTH NETWORK",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HUDSON HEADWATERS HEALTH NETWORK",
"enumeration_date": "2015-09-30",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A",
"authorized_official_last_name": "TOURNIER",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_title_or_position": "EXECUTIVE VP OF FINANCE / CFO",
"authorized_official_telephone_number": "518-761-0300"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04280466",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glens Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.