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OAK ORCHARD HEALTH - LYNDONVILLE
NPI 1407189582
Clinic/Center - Federally Qualified Health Center (FQHC) in Lyndonville, NY

Active since September 08, 2009
77 S MAIN ST, LYNDONVILLE, NY 14098(585) 765-2060(585) 765-2067 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 9, 2021, Nov 15, 2018 (2 updates tracked since 2018).

About Oak Orchard Health - Lyndonville NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OAK ORCHARD HEALTH - LYNDONVILLE (NPI 1407189582) is a healthcare organization registered as a federally qualified health center (fqhc) in Lyndonville, New York and active in the NPI registry since September 2009. The organization lists Mary Ann Pettibon, Ceo, as its authorized official.

NPPES Registry Identity

NPI1407189582
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameOAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Location Address77 S MAIN STLyndonville, NY 14098-9771
Mailing Address300 West AveBrockport, NY 14420-1118 · (585) 637-3905 · Fax (585) 637-4990
Phone(585) 765-2060
Fax(585) 765-2067
Organization SubpartYes
Authorized OfficialMary Ann PettibonCeo · (585) 637-3905
Enumeration DateSeptember 8, 2009
Last NPPES UpdateJuly 9, 20212 updates tracked since enumeration
NPPES CertifiedJuly 9, 2021
✔ NPI 1407189582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X
Also ListedClinic/Center · Migrant HealthTaxonomy 261QM1000X
77 S MAIN ST, Lyndonville, NY 14098
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Other Names 1

Doing Business AsOak Orchard Health - Lyndonville

Other Identifiers 1

Medicaid00355308NY

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. THEODORE R NADELEN III MS, RN, FNP
Nurse Practitioner (Family)
77 S MAIN ST
LYNDONVILLE, NY 14098
Orleans County (585) 765-2060
DAVID S BELL M.D.
Family Medicine
77 S MAIN ST
LYNDONVILLE, NY 14098
Orleans County (585) 765-2060

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Oak Orchard Community Health Center, Inc.'s NPI number?

The NPI number for Oak Orchard Community Health Center, Inc. is 1407189582. It was assigned to this organization in the NPPES registry on September 8, 2009. The provider is doing business as Oak Orchard Health - Lyndonville.

Where is Oak Orchard Community Health Center, Inc. located?

Oak Orchard Community Health Center, Inc. is located at 77 S Main St, Lyndonville, NY 14098. The listed phone number is (585) 765-2060.

What is Oak Orchard Community Health Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Oak Orchard Community Health Center, Inc. was last updated on July 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.