Plattsburgh State University

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

013297 Issued in NY

Legal business name

PLATTSBURGH STATE UNIVERSITY

Doing business as

North Country Regional TBI Center

Practice address

101 Broad St
Beamont 404
Plattsburgh, NY 12901-2637

Phone

(518) 564-2155

NPI assigned

Nov 18, 2011

Organization subpart

Yes

Parent organization

STATE UNIVERSITY OF NEW YORK COLLEGE AT PLATTSBURGHAs reported in NPPES

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

Authorized official

Name

Mr. Michael Edwin Simpson

Title

Director of Sponsored Research

Phone

(518) 564-2155

Specialties & licenses 2

Addresses

Other names 1

• North Country Regional TBI Center Doing business as

Tax ID family

North Country Regional Tbi Center2 organizations share this tax ID, including this one

Part of

Daniel a Spengler

Other organizations with this tax ID 1

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

• Plattsburgh State Tbi

  • Case Management Agency
  • Plattsburgh, NY
  • NPI 1578623575
  NPD tax ID

Locations

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1982971941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "address_2": "KEHOE 815",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012637",
            "telephone_number": "518-564-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "address_2": "BEAMONT 404",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012637",
            "telephone_number": "518-564-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTSBURGH STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE UNIVERSITY OF NEW YORK COLLEGE AT PLATTSBURGH",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "DIRECTOR OF SPONSORED RESEARCH",
        "authorized_official_telephone_number": "518-564-2155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "013297",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "013297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Country Regional TBI Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Plattsburgh Otolaryngology-Head and Neck Surgery, PLLC
• Plattsburgh Pediatrics PC
• Plattsburgh Podiatry Center LLP
• Plattsburgh Sports Medicine, PLLC
• Plattsburgh State Tbi
• Plattsburgh State University Speech and Hearing Center (SUNY Plattsburgh Speech & Hearing Center)
• Teresa Shine Plimpton, R.N.
• Karen Plotas-McGrath, PHN
• Jennifer Nurit Plotnick, D.M.D.
• Jenna Mariah Plows, MFT

• Clinical Neuropsychologist in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.