Crooked Lake Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

209529 Issued in NY

Legal business name

CROOKED LAKE FAMILY MEDICINE

Practice address

1930 Pre Emption Rd
Penn Yan, NY 14527-9641

Phone

(315) 536-0086

Fax

(315) 536-4107

NPI assigned

Mar 23, 2009

Organization subpart

No

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

Authorized official

Name

Lisa Walk-Reinard, MD

Title

Owner

Phone

(315) 536-0086

Specialties & licenses 1

Addresses

Practitioners 2

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

• Robert Anderson, MD

  • Family Medicine Physician
  • Penn Yan, NY
  • NPI 1255586400
  NPD (past)
• Jeffrey W Rosenberg, MD

  • Nephrology Physician
  • Rochester, NY
  • NPI 1174598288
  NPD (past)

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1992946891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1077",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144568077",
            "telephone_number": "315-536-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 PRE EMPTION RD",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145279641",
            "telephone_number": "315-536-0086",
            "fax_number": "315-536-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROOKED LAKE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "WALK-REINARD",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-536-0086",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "209529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol H Clendenin, LCSW-R
• Mark Collinsworth, RDH
• Marlene Ann Comfort, NP
• Mary Barbara Corwin, RN
• Constance Covert, LCSW
• Peggy Cummings
• Rebecca Marie Curran
• CVS Albany, L.L.C.
• Jean Marie Dabbracci, ADULT NP
• Emily Dailey

• Family Medicine Physician in Penn Yan, NY
• Providers in Penn Yan, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.