ROGER WILLIAMS MEDICAL CENTER (NPI# 1457395998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457395998 |
| Entity Type | Organization |
| Organization Name | ROGER WILLIAMS MEDICAL CENTER |
| Other Organization Name | ROGER WILLIAMS ADDICTION MEDICINE |
| Practice Address |
825 Chalkstone Ave Providence RI 02908-4728 |
| Practice Telephone | 4014562363 |
| Practice Fax Number | 4014566744 |
| Mailing Telephone | 4014562525 |
| Mailing Fax Number | 4014566742 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-03-13 |
| Authorized Official Name | KENNETH BELCHER (PRESIDENT, CEO) |
| Authorized Official Telephone | 4014562025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
HOS00108 | RI | Allopathic & Osteopathic Physicians |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
HOS00108 | RI | Behavioral Health & Social Service Providers |
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | RW18813 | 05 |
| Other Name | Type Code |
|---|---|
| ROGER WILLIAMS ADDICTION MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912253675 | Roger Williams Medical Center | Long Term Care Hospital | 25 Chalkstone Ave, Providence, RI 02908 | 2012-07-31 |
| 1477977064 | Roger Williams Medical Center | Dermatology | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2014-02-18 |
| 1063853661 | Roger Williams Medical Center | General Acute Care Hospital | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2013-07-11 |
| 1760736557 | Roger Williams Medical Center | Surgery | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2012-11-01 |
| 1710244157 | Roger Williams Medical Center | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2012-04-23 |
| 1518987981 | Roger Williams Medical Center | Surgery | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2006-07-20 |
| 1568498392 | Roger Williams Medical Center | Nutritionist | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2006-06-23 |
| 1114961729 | Roger Williams Medical Center | Home Health | 50 Maude St, Providence, RI 02908-4325 | 2006-06-15 |
| 1649278250 | Roger Williams Medical Center | General Acute Care Hospital | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2005-07-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ROGER WILLIAMS MEDICAL CENTER | 825 Chalkstone Ave, Providence, RI 02908-4728 |
| Street Address |
825 CHALKSTONE AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02908-4728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467459263 | Ritesh Rathore | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2005-07-07 |
| 1821698903 | Afsana Jahan | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-10-28 |
| 1861090508 | Anthony Joseph Paoletta | Social Worker | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-10-14 |
| 1255941720 | Georgio Medawar | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-08-08 |
| 1265042733 | Jessica Khoury | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-08-08 |
| 1215547617 | Amy Remillard | Social Worker | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-07-31 |
| 1225647738 | Abdallah Mohamed | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-07-30 |
| 1467061309 | Catherine Ekladios | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-07-27 |
| 1982213948 | Jamal Al Ali | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-07-27 |
| 1811506793 | Sadollah Ghasempour Soleymani | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2020-07-27 |
| 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 | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760977136 | Prospect Chartercare Rwmc, LLC | Internal Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2018-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386626174 | Denis E Moonan Jr. | Internal Medicine | 1515 Smith St, Suite N, North Providence, RI 02911-2947 | 2005-11-16 |
| 1821656034 | Prospect Chartercare Sjhsri, LLC | Internal Medicine | 200 High Service Ave, N Providence, RI 02904-5113 | 2019-06-03 |
| 1508049305 | Medical Assisted Recovery, Inc. | Internal Medicine | 875 Centerville Rd, Warwick, RI 02886-4381 | 2007-12-14 |
| 1538108857 | Andrew C Stone | Internal Medicine | 111 Howard Ave, Cranston, RI 02920-3001 | 2006-06-05 |
| City | PROVIDENCE |
| Zip Code | 02908 |
Please comment or provide details below to improve the information on ROGER WILLIAMS MEDICAL CENTER.
| 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.