CCS MEDICAL PRACTICE, PLLC (NPI# 1265857643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265857643 |
| Entity Type | Organization |
| Organization Name | CCS MEDICAL PRACTICE, PLLC |
| Practice Address |
17 Southdown Road Huntington NY 11743 |
| Practice Telephone | 6319232139 |
| Mailing Telephone | 3018094000 |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | MICHAEL KENNEDY (OWNER) |
| Authorized Official Telephone | 6319232139 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251K00000X | Public Health or Welfare | 7175553 | NY | Agencies |
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CCS MEDICAL PRACTICE, PLLC | 28 Liberty St., New York, New York 10005 |
| Street Address |
17 SOUTHDOWN ROAD |
| City | HUNTINGTON |
| State | NY |
| Zip Code | 11743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896477 | Peter C Gaal | Behavioral Analyst | 47 N. Woodhull Road, 2nd Floor, Huntington, NY 11743 | 2019-11-25 |
| 1902389299 | Taylor Bliss Dambrosio | Early Intervention Provider Agency | 38 Carnegie Ave, Huntington, NY 11743 | 2018-09-12 |
| 1639601750 | Speech and Hearing Services | Clinic/Center | 17 Brooks Ave Unit1, Huntington, NY 11743 | 2017-03-29 |
| 1174983456 | Helene Falcone | Registered Nurse | 264 W. 22nd St., Oakwood Primary Center, Hunt., NY 11743 | 2016-03-01 |
| 1124499470 | Thomas Hlenski | Social Worker | 4 Richard Lane, Huntington, NY 11743 | 2015-10-13 |
| 1174921308 | Jeanne Ginsberg | Counselor | 81 Knollwood Avenue, Huntington, NY 11743 | 2014-12-22 |
| 1770980534 | Emily Ann Sombke | Physician Assistant | 249 Manor Rd., Huntington, NY 11743 | 2014-11-21 |
| 1881096162 | Applied Health Chiropractic | Chiropractor | 12 Ash Pl, Huntington, NY 11743 | 2014-09-18 |
| 1255760682 | Ekaterina Femminella | Acupuncturist | 181 Main St Ste 105, Huntington, NY 11743 | 2013-11-06 |
| 1700224359 | Juliette Kraydman | Family Medicine | 270 Huntington Avenue, Huntington, NY 11743 | 2013-06-05 |
| Find all providers in zip 11743 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760023675 | Christopher Raymond Frazier | Nurse Practitioner | 234 Spring Dr, Huntington, WV 25705-3534 | 2019-10-01 |
| 1487155636 | Heather Marie Rogers | Nurse Practitioner | 940 4th Ave, Huntington, WV 25701 | 2018-02-23 |
| 1245580430 | Cabell Huntington Hospital Inc | Nurse Practitioner | 1305 Elm St E, Huntington, WV 25701-3861 | 2012-09-14 |
| 1386930337 | Abigail L. Mitchell | Nurse Practitioner | 2003 Stults Rd Ste 215, Huntington, IN 46750-1291 | 2011-06-28 |
| 1356528533 | Pamela Gayle Dice | Nurse Practitioner | 603 12th Ave, Huntington, WV 25701-3221 | 2008-01-30 |
| 1265647895 | Margaret Krepp | Nurse Practitioner | West Carver Medical Assoc., 200 West Carver St., Huntington, NY 11743-3303 | 2007-05-14 |
| 1023223641 | Christine M Colacino | Nurse Practitioner | West Carver Medical Associates, 200 West Carver St., Huntington, NY 11743-3303 | 2007-05-14 |
| 1396831608 | Jennifer M Wellman | Nurse Practitioner | 1 Timberwolf Drive, Huntington, WV 25704 | 2006-10-05 |
| 1568472512 | Jamie R Stoner | Nurse Practitioner | 2501 3rd Avenue, Huntington, WV 25703 | 2006-08-09 |
| 1326027913 | Carol Ann White | Nurse Practitioner | 6439 N Clear Creek Rd, Huntington, IN 46750-8893 | 2006-01-11 |
| Find all providers in HUNTINGTON | ||||
| City | HUNTINGTON |
| Zip Code | 11743 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.