Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162), for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1407189582
Oak Orchard Community Health Center, Inc.
Organization Subpart: YES
Active
NPI Number1407189582
NPI TypeNPI-2 Organization
SpecialtyClinic/Center, Federally Qualified Health Center (FQHC)
Provider Details
NPI1407189582
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2009-09-08
Last Updated2021-07-09
Authorized OfficialMary Ann Pettibon
CEO
Phone: 5856373905
Mailing Address300 West Ave
Brockport, NY 14420-1118
United States
Phone: (585) 637-3905 | Fax: (585) 637-4990
📍 View Map
Primary Practice Address77 S Main St
Lyndonville, NY 14098-9771
United States
Phone: (585) 765-2060 | Fax: (585) 765-2067
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNY00355308-
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No261QC1500X – Clinic/Center, Community Health--
No261QM1000X – Clinic/Center, Migrant Health--
Yes261QF0400X – Clinic/Center, Federally Qualified Health Center (FQHC)--
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About NPI 1407189582

Oak Orchard Community Health Center, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1407189582. The primary specialty listed is Clinic/Center, Federally Qualified Health Center (FQHC). The organization is located in Lyndonville, NY. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2009-09-08. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1407189582?

NPI 1407189582 belongs to Oak Orchard Community Health Center, Inc., a Clinic/Center, Federally Qualified Health Center (FQHC) in Lyndonville, NY. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1407189582 active?

The current status of NPI 1407189582 in the NPPES registry is Active. The record was last updated on 2021-07-09.

What specialty is NPI 1407189582?

NPI 1407189582 is classified under the taxonomy Clinic/Center, Federally Qualified Health Center (FQHC). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1407189582?

You can verify NPI 1407189582 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1407189582?

The primary practice address on file for NPI 1407189582 is 77 S Main St, Lyndonville, NY 14098-9771. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1407189582 issued?

NPI 1407189582 was first issued (enumerated) on 2009-09-08. The NPPES record was last updated on 2021-07-09.

Practice Location Map

Oak Orchard Community Health Center, Inc. is located at 77 S Main St, Lyndonville, NY. Use the map below to find directions or verify the practice location.

📍 77 S Main St, Lyndonville, NY 14098-9771  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Oak Orchard Community Health Center, Inc.. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-08-25 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162