Claxton Hepburn Medical Center

Primary specialty

Rehabilitation Hospital UnitTaxonomy code 273Y00000X

License

4401000H Issued in NY

Legal business name

CLAXTON HEPBURN MEDICAL CENTER

Practice address

214 King St
Ogdensburg, NY 13669-1142

Phone

(315) 393-8880

Fax

(315) 393-7250

NPI assigned

Dec 11, 2006

Organization subpart

Yes

Parent organization

CLAXTON HEPBURN MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Mr. Rob Bloom

Title

Cfo

Phone

(315) 713-5202

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

Claxton Hepburn Medical Center

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1861552549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 KING ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691142",
            "telephone_number": "315-393-8880",
            "fax_number": "315-393-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 KING ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691142",
            "telephone_number": "315-393-8880",
            "fax_number": "315-393-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAXTON HEPBURN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAXTON HEPBURN MEDICAL CENTER",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-713-5202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NY",
            "license": "4401000H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354072",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029666883",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shivangi A Chudasama-Modi, FNP
• Courtney Chudzinski
• Robert Storm Cilley, MED, ATC
• Sally A. Clark, LCSW-R
• Claxton Hepburn Medical Center
• Claxton Hepburn Medical Center
• Claxton Medical PC
• Claxton Medical PC
• Claxton-Hepburn Medical Center
• Claxton-Hepburn Medical Center

• Rehabilitation Hospital Unit in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Rehabilitation Hospital Unit in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.