Clinton County

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0952300N Issued in NY

Legal business name

CLINTON COUNTY

Practice address

16 Flynn Avenue
Plattsburgh, NY 12901-3797

Phone

(518) 563-0950

Fax

(518) 563-1060

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Martha C Pedulla

Title

Comptroller

Phone

(518) 563-0950

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clinton County Nursing Home Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335598

Legal name

CLINTON COUNTY

Doing business as

CLINTON COUNTY NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 29, 1977

Last certification

Jul 21, 2023

Beds

80

Ownership / control type

County

Organization structure

GovernmentNon-profit

Enrollment address

16 Flynn Ave
Plattsburgh, NY 12901-3707

Other NPIs with the same Medicare PAC ID 2

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

• Clinton County

  • Clinic/Center
  • Plattsburgh, NY
  • NPI 1114979945

  7618960600

  Same PAC ID
• Clinton County

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1164465902

  7618960600

  Same PAC ID

Listed as

Clinton Rehabilitation and Nursing CenterCCN 335598

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

2 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Jan 29, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8070.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Clinton County Health Department5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Clinton County

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1164465902
  NPD tax ID
• Clinton County

  • Early Intervention Provider Agency
  • Plattsburgh, NY
  • NPI 1356472088
  NPD tax ID
• Clinton County

  • Case Management Agency
  • Plattsburgh, NY
  • NPI 1396797536
  NPD tax ID
• Clinton County Health Department

  • Local Education Agency (LEA)
  • Plattsburgh, NY
  • NPI 1437101276
  NPD tax ID

All disclosed owners & managing parties 16

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

Owners & managing parties with NPI records 3

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

• Clinton County

  • Clinic/Center
  • Plattsburgh, NY
  • NPI 1114979945

  5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Clinton County

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1164465902

  5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Glenn S Schroyer, M.D.

  • Family Medicine Physician
  • Plattsburgh, NY
  • NPI 1336168780

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elisa Castillo, MSW

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1639280159
  Care Compare group
• Victoria Marie Debarbieri, APRN, BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albany, NY
  • NPI 1407992696
  Care Compare group
• Dakota Flynn, LMHC

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1053896704
  Care Compare group
• Jodi Hamel

  • Adult Health Nurse Practitioner
  • Plattsburgh, NY
  • NPI 1962958553
  Care Compare group
• Cassandra Hanley

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1477930659
  Care Compare group
• Kelly Hornby, LMSW

  • Clinical Social Worker
  • Plattsburgh, NY
  • NPI 1043371370
  Care Compare group
• Erica Lee Leonard, MHC-LP

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1184144974
  Care Compare group
• Annette-Karen Feng Miau Liem, M.D.

  • Forensic Psychiatry Physician
  • Syracuse, NY
  • NPI 1750814075
  Care Compare group
• Joshua John Morrow, LMHC

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1306727268
  Care Compare group
• Casey M Root-Caron, LMHC

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1275703589
  Care Compare group
• Christine Stowe, LMHC

  • Mental Health Counselor
  • Plattsburgh, NY
  • NPI 1699116962
  Care Compare group
• Glenn S Schroyer, M.D.

  • Family Medicine Physician
  • Plattsburgh, NY
  • NPI 1336168780
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Glenn S Schroyer, M.D.

  • Family Medicine Physician
  • Plattsburgh, NY
  • NPI 1336168780

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1992854103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FLYNN AVENUE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013797",
            "telephone_number": "518-563-0950",
            "fax_number": "518-563-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FLYNN AVENUE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013797",
            "telephone_number": "518-563-0950",
            "fax_number": "518-563-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "PEDULLA",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "518-563-0950",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "0952300N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00583624",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton County Nursing Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gail N Cleveland, LMHC
• Clinton County
• Clinton County
• Clinton County
• Clinton County
• Clinton County Health Department
• Clinton Essex Warren Washington Boces
• Clrnc Operating LLC
• Anna Rebecca Sanborn Coffin
• David E Cohen, M.D.

• All providers in Plattsburgh, NY
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.