NPIMap

Organization Active NPI

Hudson Headwaters Health Network

  • Physician Assistant
  • Warrensburg, NY
National Provider Identifier
1992719561
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3349 Issued in NY
Legal business name
HUDSON HEADWATERS HEALTH NETWORK
Practice address
3767 Main St
Warrensburg, NY 12885-1837
Phone
(518) 623-2844
Fax
(518) 623-3416
NPI assigned
Jul 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Eric Burton
Title
Chief Financial Officer
Phone
(518) 761-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3349 NY Primary

Addresses

Primary practice location

3767 Main St
Warrensburg, NY 12885-1837

Mailing address

1 Broad Street PLZ
PO Box 357
Glens Falls, NY 12801-4390
Phone (518) 761-0300

National Provider Directory

National Provider Directory
Tax ID family
Hudson Headwaters HLTH43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992719561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROAD STREET PLZ",
            "address_2": "PO BOX 357",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014390",
            "telephone_number": "518-761-0300",
            "fax_number": "518-745-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 MAIN ST",
            "city": "WARRENSBURG",
            "state": "NY",
            "postal_code": "128851837",
            "telephone_number": "518-623-2844",
            "fax_number": "518-623-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON HEADWATERS HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "518-761-0300"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "3349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.