NPIMap

Organization Active NPI

Lake Champlain OB/GYN, PC

  • Obstetrics & Gynecology Physician
  • Plattsburgh, NY
National Provider Identifier
1891708095
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LAKE CHAMPLAIN OB/GYN, PC
Practice address
206 Cornelia St
Suite 306
Plattsburgh, NY 12901-2779
Phone
(518) 566-9452
Fax
(519) 562-7189
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Jeannie S Van Nostrand
Title
Office Manager
Phone
(518) 566-9452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

206 Cornelia St
Suite 306
Plattsburgh, NY 12901-2779

Mailing address

206 Cornelia St
Suite 306
Plattsburgh, NY 12901-2779
Phone (518) 566-9452

National Provider Directory

National Provider Directory

Locations

206 Cornelia St
Ste 306
Plattsburgh, NY 12901
Phone (518) 566-9452

46 Broad St
Ste A
Plattsburgh, NY 12901
Phone (518) 566-9452

46 Broad St
Plattsburgh, NY 12901
Phone (518) 563-2550

Practitioners & affiliated clinicians

Practitioners 5

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": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1891708095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CORNELIA ST",
            "address_2": "SUITE 306",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012779",
            "telephone_number": "518-566-9452",
            "fax_number": "519-562-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CORNELIA ST",
            "address_2": "SUITE 306",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012779",
            "telephone_number": "518-566-9452",
            "fax_number": "519-562-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CHAMPLAIN OB/GYN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "VAN NOSTRAND",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-566-9452"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 3, 2014; 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.