UNIVERSITY MEDICAL GROUP, INC (NPI# 1255367942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255367942 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY MEDICAL GROUP, INC |
| Practice Address |
50 Maude St Providence RI 02908-4325 |
| Mailing Address |
825 Chalkstone Ave Providence RI 02908-4728 |
| Practice Telephone | 4014565368 |
| Mailing Telephone | 4014562717 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. TRACY WALLACE (CEO) |
| Authorized Official Telephone | 4014562717 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | UM 24173 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | UNIVERSITY MEDICAL GROUP, INC. | 1400 Sw 5th Ave Ste 500, Portland, OR 97201 |
| Street Address |
50 MAUDE ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02908-4325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013901248 | Daniel N Valicenti | Internal Medicine | 50 Maude St, 4th Floor, Providence, RI 02908-4325 | 2005-09-02 |
| 1871063891 | Integrated Wound Care Rhode Island Pllc | General Practice | 50 Maude St, Providence, RI 02908-4325 | 2018-12-03 |
| 1811402100 | Prospect Chartercare Home Health and Hospice, LLC | Registered Nurse | 50 Maude St, Providence, RI 02908-4325 | 2017-12-07 |
| 1871947093 | Samantha Mossman | Dietitian, Registered | 50 Maude St, Roger Willaims Oncology Center, Providence, RI 02908-4325 | 2016-04-14 |
| 1841679503 | Rui Cheng | Dermatology | 50 Maude St, Providence, RI 02908-4325 | 2015-05-27 |
| 1437544111 | Prospect Chartercare Physicians LLC | Clinic/Center | 50 Maude St, Providence, RI 02908-4325 | 2015-03-31 |
| 1083012173 | New University Medical Group LLC | Internal Medicine | 50 Maude St, Providence, RI 02908-4325 | 2014-12-05 |
| 1912322918 | Prospect Chartercare Rwmc, LLC | Home Health | 50 Maude St, Providence, RI 02908-4325 | 2014-02-27 |
| 1457776452 | Prospect Chartercare Elmhurst, LLC | Skilled Nursing Facility | 50 Maude St, Providence, RI 02908-4325 | 2014-02-27 |
| 1942634407 | Shareen Holly | Psychologist | 50 Maude St, Elmhurst Extended Bldg, 5th Fl, Providence, RI 02908-4325 | 2013-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771900 | Horizon Wellness | Clinic/Center | 1339 Smith St, North Providence, RI 02908 | 2017-10-12 |
| 1477098069 | Beth Perry | Nurse Practitioner | 830 Chalstone Ave., Providence, RI 02908 | 2017-01-05 |
| 1659788735 | Brandi Kimble | Podiatrist | 825 Chalkstone Avenue, Providence, RI 02908 | 2014-07-21 |
| 1912253675 | Roger Williams Medical Center | Long Term Care Hospital | 25 Chalkstone Ave, Providence, RI 02908 | 2012-07-31 |
| 1669768818 | Elisa Semedo | Physical Therapist | 285 Promenade Street, Providence, RI 02908 | 2011-06-27 |
| 1255655502 | Caregiver Homes of Rhode Island Inc. | Custodial Care Facility | 235 Promenade Street, Providence, RI 02908 | 2010-03-16 |
| 1487884987 | Professional Ambulance LLC | Ambulance | 52 River Ave, Providence, RI 02908 | 2009-07-17 |
| 1609065804 | Stephen W Davis | Family Medicine | 299 Promenade Street, Nhpri, Providence, RI 02908 | 2007-10-24 |
| 1205053899 | John R Ricci | Dentist | 1252 Smith St, Providence, RI 02908 | 2007-04-18 |
| 1871718718 | Brett C Auclaire | Nurse Practitioner | 40 Candace Street, Providence, RI 02908 | 2007-04-16 |
| Find all providers in zip 02908 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033345632 | Barrington Urgent Care, PC | Clinic/Center | 381 Wickenden St, Providence, RI 02903-4425 | 2009-06-09 |
| 1124516349 | Recovery Connection Centers of America, Inc. | Clinic/Center | 381 Wickenden St, Providence, RI 02903-4425 | 2018-04-24 |
| 1669726451 | The Miriam Hospital | Clinic/Center | 164 Summit Ave, 2rd Floor Fain Building, Providence, RI 02906-2853 | 2012-11-01 |
| 1164716031 | The Miriam Hospital | Clinic/Center | 146 W River St, Providence, RI 02904-2609 | 2011-06-08 |
| 1194977058 | Rhode Island Hospital | Clinic/Center | 167 Point St, Providence, RI 02903-4771 | 2008-10-22 |
| 1972768174 | Rhode Island Hospital | Clinic/Center | 593 Eddy St, Providence, RI 02903-4923 | 2008-07-28 |
| 1942323068 | Rhode Island Hospital | Clinic/Center | 593 Eddy St, Providence, RI 02903-4923 | 2007-04-06 |
| 1154443885 | Meeting Street Center | Clinic/Center | 1000 Eddy Street, Providence, RI 02905 | 2007-04-04 |
| 1053447433 | Family Service of Rhode Island Inc | Clinic/Center | 1246 Chalkstone Ave, Providence, RI 02908-3904 | 2007-02-27 |
| 1639214281 | Family Service of Rhode Island Inc. | Clinic/Center | 55 Hope St, Providence, RI 02906-2001 | 2007-02-21 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02908 |
Please comment or provide details below to improve the information on UNIVERSITY MEDICAL GROUP, 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.