NPIMap

Organization Active NPI

Upstate Pca Institute

  • Adult Companion
  • Utica, NY
National Provider Identifier
1881436756
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Legal business name
UPSTATE PCA INSTITUTE
Practice address
1216 Gray Ave
Utica, NY 13502-3959
Phone
(315) 542-4209
NPI assigned
Jun 11, 2024
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Shannon Green, HHANPI 1073256616
Title
Suporvisor/Provider
Phone
(315) 542-4209

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X Primary

Addresses

Primary practice location

1216 Gray Ave
Utica, NY 13502-3959

Mailing address

1216 Gray Ave Apt 2F
Utica, NY 13502-3967
Phone (315) 542-4209

National Provider Directory

National Provider Directory
Tax ID family
Upstate Pca Institute3 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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1881436756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 GRAY AVE APT 2F",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135023967",
            "telephone_number": "315-542-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 GRAY AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135023959",
            "telephone_number": "315-542-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PCA INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "SUPORVISOR/PROVIDER",
        "authorized_official_telephone_number": "315-542-4209",
        "authorized_official_credential": "HHA"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.