Claxton-Hepburn Medical Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

CLAXTON-HEPBURN MEDICAL CENTER

Practice address

4 Montgomery HTS
Waddington, NY 13694-7712

Phone

(315) 388-7872

NPI assigned

Sep 16, 2020

Last updated

Jan 26, 2022By the provider in NPPES

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

Rob Bloom

Title

Cfo

Phone

(315) 713-5202

Specialties & licenses 1

Addresses

Other names 1

• Waddington Health Center Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Claxton Hepburn Medical Center

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Carthage Area Hospital Inc

  dba Waddington Health Center

  • Rural Health Clinic/Center
  • Waddington, NY
  • NPI 1871365072

  Sold to, 2023-12-19

  CMS change of ownership

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1922614973",
    "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": "315-393-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MONTGOMERY HTS",
            "city": "WADDINGTON",
            "state": "NY",
            "postal_code": "136947712",
            "telephone_number": "315-388-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAXTON-HEPBURN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAXTON HEPBURN MEDICAL CENTER",
        "enumeration_date": "2020-09-16",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waddington Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Waddington Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christine Backus, TOD
• Peggy Leigh Baker, LCSWR
• Melissa Baxter
• Karen Cameron, PT
• Carthage Area Hospital Inc (Waddington Health Center)
• Chandler S Crosby, PT
• Jacqueline Danis, TVI
• Tessa Durand, OCCUPATIONAL THERAPY
• Hillary Durant, SLP
• Malorie Ann Farrell, D.C.

• Rural Health Clinic/Center in Waddington, NY
• Providers in Waddington, NY by specialty
• Rural Health Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.