| Anthony L. Jordan Health Corporation | |
|
120 N Main St Suite 11 Canandaigua NY 14424-1258 | |
| (585) 396-6980 | |
| Not Available |
| Full Name | Anthony L. Jordan Health Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 N Main St, Canandaigua, New York |
| Authorized Official Name and Position | Bridgette Wiefling (PRESIDENT/CEO) |
| Authorized Official Contact | 5854232878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony L. Jordan Health Corporation 82 Holland Street Rochester NY 14605-2131 Ph: () - | Anthony L. Jordan Health Corporation 120 N Main St Suite 11 Canandaigua NY 14424-1258 Ph: (585) 396-6980 |
| NPI Number | 1649529678 |
|---|---|
| Provider Enumeration Date | 09/06/2012 |
| Last Update Date | 09/07/2012 |
| Medicare PECOS PAC ID | 8729079785 |
|---|---|
| Medicare Enrollment ID | O20040519001335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649529678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Richard G Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881659845 PECOS PAC ID: 4880596683 Enrollment ID: I20040122000797 |
| Provider Name | Colleen T Fogarty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801816954 PECOS PAC ID: 0143219824 Enrollment ID: I20040507001242 |
| Provider Name | Steven G Becker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861441404 PECOS PAC ID: 8729079603 Enrollment ID: I20040519001500 |
| Provider Name | Sandra L Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801810874 PECOS PAC ID: 5092791137 Enrollment ID: I20040628001592 |
| Provider Name | Basya V Herbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912943812 PECOS PAC ID: 6709848724 Enrollment ID: I20041102000510 |
| Provider Name | Assaf Yosha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558397752 PECOS PAC ID: 9133186497 Enrollment ID: I20041217000714 |
| Provider Name | John C Dickinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487686622 PECOS PAC ID: 5193745461 Enrollment ID: I20051201000171 |
| Provider Name | Steven M Fine |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1780682351 PECOS PAC ID: 5395759120 Enrollment ID: I20060201000387 |
| Provider Name | Katherine P O Hanlon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134152275 PECOS PAC ID: 5698781094 Enrollment ID: I20060222000386 |
| Provider Name | Leslie E Purnell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689621500 PECOS PAC ID: 6103839287 Enrollment ID: I20060712000143 |
| Provider Name | Kara Lee Eastwood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659310522 PECOS PAC ID: 3779556907 Enrollment ID: I20060929000342 |
| Provider Name | Gail A Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700908811 PECOS PAC ID: 3375634629 Enrollment ID: I20070822000353 |
| Provider Name | Mary C Angerame |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093886830 PECOS PAC ID: 4486743861 Enrollment ID: I20071207000808 |
| Provider Name | Benjamin Ray Christensen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801805585 PECOS PAC ID: 9234214701 Enrollment ID: I20080307000230 |
| Provider Name | Ellen M Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730363383 PECOS PAC ID: 5294814786 Enrollment ID: I20080508000744 |
| Provider Name | Linda Levita Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720249147 PECOS PAC ID: 4587736921 Enrollment ID: I20080701000029 |
| Provider Name | Diane S Morse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770552341 PECOS PAC ID: 1850465303 Enrollment ID: I20080801000327 |
| Provider Name | Colby Ah Previte |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801805320 PECOS PAC ID: 9638238058 Enrollment ID: I20081030000101 |
| Provider Name | Katrina F Nicandri |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316056286 PECOS PAC ID: 9739286469 Enrollment ID: I20090807000241 |
| Provider Name | Leesha Kerene Hoilette |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881767150 PECOS PAC ID: 1759475437 Enrollment ID: I20090825000587 |
| Provider Name | Wilhelmina Sizer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689851164 PECOS PAC ID: 1153499140 Enrollment ID: I20091015000518 |
| Provider Name | Bradley Vanheukelum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841213022 PECOS PAC ID: 9537207188 Enrollment ID: I20091119000110 |
| Provider Name | Jeanne C Beddoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902847882 PECOS PAC ID: 7618006255 Enrollment ID: I20100520000342 |
| Provider Name | Roksolana Kuchma |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1063435238 PECOS PAC ID: 9931233095 Enrollment ID: I20100812000009 |
| Provider Name | Carole J Peterson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639132798 PECOS PAC ID: 4486698230 Enrollment ID: I20101208000841 |
| Provider Name | Laura L Hayton Oechsle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902120124 PECOS PAC ID: 9234310418 Enrollment ID: I20110221000981 |
| Provider Name | Holly A Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013123389 PECOS PAC ID: 7719161868 Enrollment ID: I20110413001028 |
| Provider Name | Nashat Atalla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245208065 PECOS PAC ID: 8921020934 Enrollment ID: I20110516000194 |
| Provider Name | Soon Il Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063464386 PECOS PAC ID: 1759381213 Enrollment ID: I20110802000424 |
| Provider Name | Sakinah N Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538173679 PECOS PAC ID: 1557530318 Enrollment ID: I20110811000549 |
| Provider Name | Heidi R Zinkand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225056294 PECOS PAC ID: 4284804626 Enrollment ID: I20110823000430 |
| Provider Name | Faith Debra Adams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316914609 PECOS PAC ID: 7911171954 Enrollment ID: I20111201000027 |
| Provider Name | Kevin A Fiscella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144332818 PECOS PAC ID: 2769622562 Enrollment ID: I20130627000665 |
| Provider Name | Elizabeth L Loomis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063647915 PECOS PAC ID: 4284890880 Enrollment ID: I20130806000262 |
| Provider Name | J Derek Brederson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790063162 PECOS PAC ID: 5890921431 Enrollment ID: I20131204000337 |
| Provider Name | Lorinda F Parks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275617979 PECOS PAC ID: 2961597836 Enrollment ID: I20140108001321 |
| Provider Name | Liz Munoz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962613174 PECOS PAC ID: 8022246040 Enrollment ID: I20140120000087 |
| Provider Name | Thecla I Obi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679801633 PECOS PAC ID: 0840424743 Enrollment ID: I20140224001499 |
| Provider Name | Melanie Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609142587 PECOS PAC ID: 3274758826 Enrollment ID: I20140715002134 |
| Provider Name | Jericho Banker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518220441 PECOS PAC ID: 6002032976 Enrollment ID: I20140730000016 |
| Provider Name | Thomas Robert Gregg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639339146 PECOS PAC ID: 2365760899 Enrollment ID: I20150414001280 |
| Provider Name | Prity J Rawal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851650998 PECOS PAC ID: 8426287095 Enrollment ID: I20150828000342 |
| Provider Name | Emily J Thompson-carrillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639468275 PECOS PAC ID: 5193033173 Enrollment ID: I20150925000445 |
| Provider Name | Blessing A Ibezim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174914964 PECOS PAC ID: 4981912904 Enrollment ID: I20160303000735 |
| Provider Name | Mary Li Ma |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356606263 PECOS PAC ID: 7517267149 Enrollment ID: I20160819000736 |
| Provider Name | Rosamond Reffell-pugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891087771 PECOS PAC ID: 7618256421 Enrollment ID: I20161118001933 |
| Provider Name | Hollis Ann Biggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164781498 PECOS PAC ID: 8628359718 Enrollment ID: I20170104000430 |
| Provider Name | Vladimir Taub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992250997 PECOS PAC ID: 2264716471 Enrollment ID: I20170308001101 |
| Provider Name | Emily K Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235590282 PECOS PAC ID: 9234414228 Enrollment ID: I20170313001725 |
| Provider Name | Bess M Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336688993 PECOS PAC ID: 2668759606 Enrollment ID: I20170501001252 |
| Provider Name | Lawrence Shawndel Brumfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750695615 PECOS PAC ID: 8426326406 Enrollment ID: I20170615001075 |
| Provider Name | Branko Matich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023437704 PECOS PAC ID: 4981974854 Enrollment ID: I20170726000178 |
| Provider Name | Sarah Elizabeth Hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740417039 PECOS PAC ID: 8820233364 Enrollment ID: I20170801003125 |
| Provider Name | Danielle B Fleissig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073932315 PECOS PAC ID: 8628349008 Enrollment ID: I20170803000009 |
| Provider Name | Colleen A Obrien |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487162533 PECOS PAC ID: 7113287137 Enrollment ID: I20180212001238 |
| Provider Name | Megan E Betteley Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083092910 PECOS PAC ID: 5890042501 Enrollment ID: I20180725002802 |
| Provider Name | Davya S. Brody |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164735320 PECOS PAC ID: 6305198268 Enrollment ID: I20181004001699 |
| Provider Name | Fanny Lean Ho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649774183 PECOS PAC ID: 8022362276 Enrollment ID: I20181107001036 |
| Provider Name | Jennifer A Ashley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992175681 PECOS PAC ID: 5890035232 Enrollment ID: I20190320002864 |
| Provider Name | Nicole B Erlichman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992212799 PECOS PAC ID: 6002140167 Enrollment ID: I20190624000680 |
| Provider Name | Lauren N Hobbs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831545516 PECOS PAC ID: 7012260078 Enrollment ID: I20190624002760 |
| Provider Name | Kimberlie A Noyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700429461 PECOS PAC ID: 1850729658 Enrollment ID: I20200310000124 |
| Provider Name | Avellina Ihuaku Okafor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073159679 PECOS PAC ID: 8820426562 Enrollment ID: I20200312000485 |
| Provider Name | Caroline Rb Donohue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730614843 PECOS PAC ID: 6204189194 Enrollment ID: I20200612000860 |
| Provider Name | Nicholas D David |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740715564 PECOS PAC ID: 5991075962 Enrollment ID: I20200914000188 |
| Provider Name | Nina G Piazza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659805026 PECOS PAC ID: 5294005054 Enrollment ID: I20200919000010 |
| Provider Name | Michelle Magee Devens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629603998 PECOS PAC ID: 6204255409 Enrollment ID: I20201007000503 |
| Provider Name | Lisa M Denmark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912528142 PECOS PAC ID: 6002226016 Enrollment ID: I20201103001334 |
| Provider Name | La Carla Denise Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760682751 PECOS PAC ID: 3072924141 Enrollment ID: I20201120000514 |
| Provider Name | Lillian A Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730709296 PECOS PAC ID: 7416360995 Enrollment ID: I20201229002414 |
| Provider Name | Sara Joyce Klatte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124491592 PECOS PAC ID: 8921390998 Enrollment ID: I20210401001764 |
| Provider Name | Tariq Jamal Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235627472 PECOS PAC ID: 4082951488 Enrollment ID: I20210817002692 |
| Provider Name | Dzheikhuna Mamedova |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952953945 PECOS PAC ID: 9234541467 Enrollment ID: I20210819000355 |
| Provider Name | Matthew T Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598256190 PECOS PAC ID: 4183977143 Enrollment ID: I20210901001904 |
| Provider Name | Jaslynn Renee Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790350890 PECOS PAC ID: 1052701976 Enrollment ID: I20211208003505 |
| Provider Name | Jason Stewart |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801568613 PECOS PAC ID: 4385038892 Enrollment ID: I20220228000425 |
| Provider Name | Sarah M Tiggelaar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376806851 PECOS PAC ID: 7113172651 Enrollment ID: I20230113001633 |
Medsmith Medical Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 241 Parrish St, Suite B, Canandaigua, NY 14424 Phone: 585-394-8170 Fax: 585-394-8173 | |
Clemensen Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 S Main St, Suite 5, Canandaigua, NY 14424 Phone: 866-269-4810 Fax: 866-269-4810 | |
Farmington Family Practice Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 495 N Main St, Canandaigua, NY 14424 Phone: 585-393-3515 Fax: 585-393-3515 | |
Bloomfield Family Practice, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6032 Woodvine Rise, Canandaigua, NY 14424 Phone: 585-202-5022 | |
Canandaigua Medical Group, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 Parrish St, Canandaigua, NY 14424 Phone: 585-393-2888 Fax: 585-396-9275 | |
Lake Country Family Medicine, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 S Main St, Suite G, Canandaigua, NY 14424 Phone: 585-394-1875 Fax: 866-285-9069 |