County of Otsego

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3859300N Issued in NY

Legal business name

COUNTY OF OTSEGO

Doing business as

Otsego Manor

Practice address

128 Phoenix Mills Cross Rd
Cooperstown, NY 13326-5716

Phone

(607) 544-2600

Fax

(607) 544-2716

NPI assigned

Jan 3, 2006

Last updated

Sep 28, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edmond Marchi

Title

Administrator

Phone

(607) 544-2660

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Otsego Manor Doing business as

Tax ID family

CCRN Operator LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• CCRN Operator LLC

  dba Focus Rehabilitation & Nursing at Otsego

  • Skilled Nursing Facility
  • Cooperstown, NY
  • NPI 1811397995
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• County of Otsego

  dba Otsego County Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oneonta, NY
  • NPI 1831145101

  Member Of

  NPD member

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1891773701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PHOENIX MILLS CROSS RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133265716",
            "telephone_number": "607-544-2600",
            "fax_number": "607-547-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 PHOENIX MILLS CROSS RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133265716",
            "telephone_number": "607-544-2600",
            "fax_number": "607-544-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF OTSEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-03",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "MARCHI",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "607-544-2660",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "3859300N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00356414",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otsego Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trista Corsino
• Nancy Coulehan, R.D., C.D.E.
• County of Otsego (Otsego Manor Lthhcp)
• County of Otsego
• County of Otsego
• Lindsey Marie Coutlee, FNP-C
• Jill C. Craig, D.C.
• Linda W Craig, MSN RN CS
• Matthew Douglas Craig, D.C.
• David I Cramer, D.O.

• Skilled Nursing Facility in Cooperstown, NY
• Providers in Cooperstown, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.