NPIMap

Organization Active NPI

Adirondack Interventional Physiatry PC

Doing business as Champlain Spine & Pain Mgt

  • Interventional Pain Medicine Physician
  • Plattsburgh, NY
National Provider Identifier
1821166166
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
231566 Issued in NY
Legal business name
ADIRONDACK INTERVENTIONAL PHYSIATRY PC
Doing business as
Champlain Spine & Pain Mgt
Practice address
4 Feathers Dr
Plattsburgh, NY 12901-6461
Phone
(518) 324-7246
Fax
(518) 324-3366
NPI assigned
Dec 4, 2006
Last updated
Jun 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Authorized official

Name
Dr. Thierry Bonnabesse, MDNPI 1487749974
Title
Owner/President
Phone
(518) 324-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 231566 NY Primary

Addresses

Primary practice location

4 Feathers Dr
Plattsburgh, NY 12901-6461

Mailing address

4 Feathers Dr
Plattsburgh, NY 12901-6461
Phone (518) 324-7246

Other practice location 1

463 Mountain View Dr Ste 103
Colchester, VT 05446-5952
Phone (518) 324-7246

Other names 1

  • Champlain Spine & Pain Mgt Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915001079 NY Part B Supplier - Clinic/Group Practice 1254308463 Receives reassigned benefits from 15 practitioners
Practice locations: Lake Placid, NY; Platsburgh, NY; Plattsburgh, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1094307Adirondack Interventional Physiatry PC4 Feathers Drive, Plattsburgh, NY 12901Certificate of waiverJan 14, 2027

National Provider Directory

National Provider Directory

Locations

294 Tom Miller Rd
Plattsburgh, NY 12901
Phone (518) 324-6569

85 Plaza Blvd
#102
Plattsburgh, NY 12901
Phone (518) 324-7246

463 Mountain View Dr
Ste 103
Colchester, VT 05446

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1821166166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FEATHERS DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016461",
            "telephone_number": "518-324-7246",
            "fax_number": "518-324-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FEATHERS DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016461",
            "telephone_number": "518-324-7246",
            "fax_number": "518-324-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "463 Mountain View Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Colchester",
            "state": "VT",
            "postal_code": "054465952",
            "country_code": "US",
            "telephone_number": "518-324-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADIRONDACK INTERVENTIONAL PHYSIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "BONNABESSE",
        "authorized_official_first_name": "THIERRY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "518-324-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "231566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champlain Spine & Pain Mgt",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Champlain Spine & Pain Mgt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.