PROSPECT CHARTERCARE ELMHURST, LLC (NPI# 1457776452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457776452 |
| Entity Type | Organization |
| Organization Name | PROSPECT CHARTERCARE ELMHURST, LLC |
| Other Organization Name | ELMHURST EXTENDED CARE FACILITY |
| Practice Address |
50 Maude St Providence RI 02908-4325 |
| Practice Telephone | 4014562623 |
| Practice Fax Number | 4014566862 |
| Mailing Telephone | 4014562623 |
| Mailing Fax Number | 4014566862 |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-02-27 |
| Authorized Official Name | ELLEN SHIN (SECRETARY) |
| Authorized Official Telephone | 3239434520 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | LTC00663 | RI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 4105084 | 05 |
| Other Name | Type Code |
|---|---|
| Elmhurst Extended Care Facility | Doing Business As Name - Organization |
| 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 |
| 1942634407 | Shareen Holly | Psychologist | 50 Maude St, Elmhurst Extended Bldg, 5th Fl, Providence, RI 02908-4325 | 2013-09-02 |
| 1568707735 | Charlene Beth Botelho | Occupational Therapy Assistant | 50 Maude St, Providence, RI 02908-4325 | 2012-11-29 |
| 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174986608 | Theodore J Hardgrove | Skilled Nursing Facility | 174 Woodward Rd, Providence, RI 02904-1720 | 2016-04-01 |
| 1730219619 | Steere House | Skilled Nursing Facility | 100 Borden St, Providence, RI 02903-4803 | 2007-03-07 |
| 1881684736 | Charlesgate Nursing Center | Skilled Nursing Facility | 100 Randall St, Providence, RI 02904-2723 | 2005-10-24 |
| 1356338248 | Bethany Home of Rhode Island | Skilled Nursing Facility | 111 South Angell Street, Providence, RI 02906-5397 | 2005-10-05 |
| 1528060290 | Episcopal Housing Foundation of Rhode Island | Skilled Nursing Facility | 66 Benefit St, Providence, RI 02904-2742 | 2005-08-12 |
| 1891797858 | Rosewood Manor, Ltd | Skilled Nursing Facility | 140 Pitman St, Providence, RI 02906-5113 | 2005-06-02 |
| 1336513811 | Src Providence, LLC | Skilled Nursing Facility | 353 Blackstone Blvd, Providence, RI 02906-4936 | 2015-11-20 |
| 1205203569 | Park View Operations Associates LLC | Skilled Nursing Facility | 31 Parade St, Providence, RI 02909-1720 | 2015-08-21 |
| 1184008088 | Bannister Operations Assoc LLC | Skilled Nursing Facility | 135 Dodge St, Street, Providence, RI 02907-2210 | 2015-07-10 |
| 1184892374 | Summit Ri Snf, LLC | Skilled Nursing Facility | 99 Hillside Ave, Providence, RI 02906-2943 | 2008-02-11 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02908 |
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| 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.