NPIMap

Organization Active NPI

Whitney M. Young, Jr. Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albany, NY
National Provider Identifier
1942573027
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
0101205R Issued in NY
Legal business name
WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.
Practice address
274 S Pearl St
Albany, NY 12202-1829
Phone
(518) 475-6723
NPI assigned
Feb 20, 2012
Last updated
Dec 18, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Authorized official

Name
David Harold Shippee
Title
President & Ceo
Phone
(518) 591-4459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 0101205R NY Primary

Addresses

Primary practice location

274 S Pearl St
Albany, NY 12202-1829

Mailing address

920 Lark Drive
Whitney M. Young Jr. Health Center
Albany, NY 12207
Phone (518) 465-4771

Other practice location 1

920 Lark Drive
Whitney M. Young Jr. Health Center, Inc.
Albany, NY 12207
Phone (518) 465-4771

Other names 1

  • Giffen Memorial Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181226000207 NY Part A Provider - Federally Qualified Health Center (FQHC) 6507830031 Practice locations: Albany, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942573027. Details of each certification follow.

Federally qualified health center certification: CCN 571144

Legal name
WHITNEY M YOUNG JR HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 28, 2018
Last certification
Dec 28, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 11, 2007 in NY
Enrollment address
274 S Pearl St
Albany, NY 12202-1829

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Whitney M Young Jr Health15 organizations share this tax ID, including this one
Part of
Whitney M Young Jr Health

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
La'Keysha Marshall Individual Corporate DirectorDirector of Revenue Cycle Mar 24, 2024
W-2 Managing EmployeeDirector of Revenue Cycle Mar 24, 2024
Gus Birkhead Individual Corporate DirectorBoard Member Apr 12, 2022
Casey Parker Individual Corporate DirectorBoard Member Apr 6, 2021
Charles Welge Individual Corporate DirectorBoard Member Apr 9, 2024
David Harold Shippee Individual Corporate DirectorPresident & Ceo Apr 28, 2011
W-2 Managing EmployeePresident & Ceo Apr 28, 2011
Gary Guy Individual Corporate DirectorBoard Member Apr 11, 2023
Annette Johnson Individual Corporate DirectorBoard Member Apr 11, 2023
Nathan Gardner Individual Corporate DirectorBoard Member Apr 8, 2025
Christopher Chase Individual Corporate DirectorBoard Member Apr 8, 2025
Tracey Johnson Individual Corporate DirectorBoard Member Apr 11, 2023
Anthony Thompson Individual Corporate DirectorBoard Member Apr 8, 2025
John E Fraher Individual Corporate DirectorCfo Nov 19, 2018
W-2 Managing EmployeeCfo Nov 19, 2018
Kelli Arnold Individual Corporate DirectorBoard Member May 14, 2024
Lauri Rosmarin-Plattner Individual Corporate DirectorBoard Member Apr 11, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1942573027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 LARK DRIVE",
            "address_2": "WHITNEY M. YOUNG JR. HEALTH CENTER",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12207",
            "telephone_number": "518-465-4771",
            "fax_number": "518-242-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 S PEARL ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122021829",
            "telephone_number": "518-475-6723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Lark Drive",
            "address_2": "Whitney M. Young Jr. Health Center, Inc.",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12207",
            "country_code": "US",
            "telephone_number": "518-465-4771",
            "fax_number": "518-242-4770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITNEY M. YOUNG, JR. HEALTH CENTER, INC.",
        "enumeration_date": "2012-02-20",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "SHIPPEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "518-591-4459"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "0101205R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giffen Memorial Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.