NPIMap

Organization Active NPI

Samaritan Hospital of Troy, New York

  • Family Medicine Physician
  • Stillwater, NY
National Provider Identifier
1912480971
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAMARITAN HOSPITAL OF TROY, NEW YORK
Practice address
1111 Hudson Avenue
Stillwater, NY 12170-3439
Phone
(518) 664-3242
NPI assigned
Sep 14, 2018
Last updated
Mar 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN HOSPITAL OF TROY, NEW YORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Authorized official

Name
Courtney Knowles
Title
Credentialing Manager
Phone
(518) 525-5634

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
General Acute Care Hospital 282N00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

1111 Hudson Avenue
Stillwater, NY 12170-3439

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other names 1

  • Stillwater Family Health Center Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct Samaritan Hospital of Troy, New York

National Provider Directory

National Provider Directory
Tax ID family
Amelia M Dodge MD27 organizations share this tax ID, including this one
Part of
Amelia M Dodge MD

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1912480971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HUDSON AVENUE",
            "city": "STILLWATER",
            "state": "NY",
            "postal_code": "121703439",
            "telephone_number": "518-664-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN HOSPITAL OF TROY, NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN HOSPITAL OF TROY, NEW YORK",
        "enumeration_date": "2018-09-14",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "Samaritan Hospital of Troy, New York",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1111 Hudson Avenue",
            "city": "Stillwater",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121703439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Stillwater Family Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stillwater, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.