THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC (NPI# 1053313593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053313593 |
| Entity Type | Organization |
| Organization Name | THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC |
| Practice Address |
375 Allens Ave Providence RI 02905-5010 |
| Practice Telephone | 4014440400 |
| Practice Fax Number | 4014440468 |
| Mailing Telephone | 4014440400 |
| Mailing Fax Number | 4014440468 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2017-05-05 |
| Authorized Official Name | MR. GREGORY YOUNG (VP/CFO) |
| Authorized Official Telephone | 4014440400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
========= | RI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 7001361 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417959867 | The Providence Community Health Centers, Inc | Clinic/Center | 355 Prairie Ave, Providence, RI 02905-5010 | 2005-08-15 |
| 1083138572 | The Providence Community Health Centers, Inc | Clinic/Center | 1 Randall Sq, Providence, RI 02904-2709 | 2017-07-27 |
| Street Address |
375 ALLENS AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905-5010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686942 | Renee Morais | Student in an Organized Health Care Education/Training Program | 375 Allens Ave, Providence, RI 02905-5010 | 2020-10-09 |
| 1427343128 | Heidi N Kurrus | Nurse Practitioner | 375 Allens Ave, Providence, RI 02905-5010 | 2011-06-10 |
| 1902059785 | Jorge Maida Luquetta | Family Medicine | 375 Allens Ave, Providence, RI 02905-5010 | 2008-10-24 |
| 1326246604 | Melinda J Hooton | Internal Medicine | 375 Allens Ave, Providence, RI 02905-5010 | 2007-07-06 |
| 1770788218 | Anne Lawrence Murray | Obstetrics & Gynecology | 375 Allens Ave, Providence, RI 02905-5010 | 2007-06-15 |
| 1841358587 | Ivan Stuart Wolfson | Family Medicine | 375 Allens Ave, Providence, RI 02905-5010 | 2006-12-05 |
| 1043240864 | Mario Italo Martinez | Pediatrics | 375 Allens Ave, Providence, RI 02905-5010 | 2006-07-04 |
| 1235186107 | Debra M Stimson | Obstetrics & Gynecology | 375 Allens Ave, Providence, RI 02905-5010 | 2006-05-27 |
| 1528016334 | Suzanne Bornschein | Internal Medicine | 375 Allens Ave, Providence, RI 02905-5010 | 2006-05-04 |
| 1891775128 | The Providence Community Health Centers, Inc. | Community/Behavioral Health | 375 Allens Ave, Providence, RI 02905-5010 | 2006-01-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174576342 | The Providence Community Health Centers, Inc. | Clinic/Center | 1 Warren Way, Providence, RI 02905-5000 | 2006-05-18 |
| 1821090358 | The Providence Community Health Centers, Inc. | Clinic/Center | 100 Curtis St, Providence, RI 02909-3623 | 2005-08-15 |
| 1295737666 | The Providence Community Health Centers, Inc. | Clinic/Center | 325 Public St, Providence, RI 02905-2340 | 2005-08-15 |
| 1669474102 | The Providence Community Health Centers, Inc. | Clinic/Center | 40 Candace St, Providence, RI 02908-3747 | 2005-08-15 |
| 1508868035 | The Providence Community Health Centers, Inc. | Clinic/Center | 239 Cranston St, Providence, RI 02907-2406 | 2005-08-15 |
| 1417959867 | The Providence Community Health Centers, Inc | Clinic/Center | 355 Prairie Ave, Providence, RI 02905-5010 | 2005-08-15 |
| 1083138572 | The Providence Community Health Centers, Inc | Clinic/Center | 1 Randall Sq, Providence, RI 02904-2709 | 2017-07-27 |
| 1215478219 | The Providence Community Health Centers, Inc. | Clinic/Center | 335 Prairie Ave, Providence, RI 02905-1924 | 2017-03-10 |
| 1649546938 | Bear Lake Community Health Centers | Clinic/Center | 517 W 100 N Ste 110, Providence, UT 84332-9826 | 2012-03-30 |
| 1558650986 | The Providence Community Health Centers Inc. | Clinic/Center | 530 N Main St, Providence, RI 02904-5762 | 2011-04-06 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02905 |
Please comment or provide details below to improve the information on THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC.
| 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.