LIFESTYLE MEDICINE OF RHODE ISLAND, LLC (NPI# 1568978690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568978690 |
| Entity Type | Organization |
| Organization Name | LIFESTYLE MEDICINE OF RHODE ISLAND, LLC |
| Other Organization Name | RI WEIGHTLOSS, LLC |
| Practice Address |
1524 Atwood Ave Ste 336 Johnston RI 02919-3228 |
| Practice Telephone | 4012286844 |
| Practice Fax Number | 4012286855 |
| Mailing Telephone | 4012286844 |
| Mailing Fax Number | 4012286855 |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |
| Authorized Official Name | MRS. MARTHA MARY FONTAINE (PRACTICE MANAGER) |
| Authorized Official Telephone | 4012286844 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QB0002X |
Family Medicine Specialization: Obesity Medicine |
MD04110 | RI | Allopathic & Osteopathic Physicians |
| N | 2083B0002X |
Preventive Medicine Specialization: Obesity Medicine |
MD04110 | RI | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | MD04110 | RI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| RI Weightloss, LLC | Former Legal Business Name - Organization |
| Street Address |
1524 ATWOOD AVE STE 336 |
| City | JOHNSTON |
| State | RI |
| Zip Code | 02919-3228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427676709 | Jessica Lawler | Nurse Practitioner | 1524 Atwood Ave Ste 336, Johnston, RI 02919-3228 | 2020-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659935757 | Cheryl K. D'itri | Massage Therapist | 2051 Plainfield Pike, Johnston, RI 02919 | 2019-04-24 |
| 1013401124 | Cigna Onsite Health LLC | Clinic/Center | 735 Greenville Ave, Bldg D, Johnston, RI 02919 | 2018-06-21 |
| 1659862803 | Michaele Marie Colizza | Massage Therapist | 1524 Atwood Ave Ste 213, Johnston, RI 02919 | 2018-05-23 |
| 1609396613 | Peter Dionisopoulos | Physical Therapist | 12 Industrial Ln, Johnston, RI 02919 | 2017-06-21 |
| 1306382932 | Marcie E Diorio | Social Worker | 1126 Hartford Avenue Tri-county Community Action Agency, Johnston, RI 02919 | 2017-01-06 |
| 1467735720 | Robert Tortolani | Pharmacist | 1387 Plaindield St., Johnston, RI 02919 | 2011-09-23 |
| 1518288075 | Vito F. Ferri | Internal Medicine | 1539 Atwood Ave., Suite 101, Johnston, RI 02919 | 2010-06-18 |
| 1497073894 | Usv Optical Inc. | Technician/Technologist | 200 Stone Hill Drive, Johnston, RI 02919 | 2010-05-10 |
| 1922239995 | Heidi C. O'grady | Physical Therapist | 1529 Atwood Avenue, Suite 202, Johnston, TX 02919 | 2009-08-07 |
| 1184855397 | Holly Batura | Counselor | 1516 Hartford Avenue, Johnston, RI 02919 | 2009-08-05 |
| Find all providers in zip 02919 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326575317 | Tyler Steven Olson | Family Medicine | 5501 Nw 86th St Ste 300, Johnston, IA 50131-1810 | 2017-05-22 |
| 1134499742 | Thomas Charles Evans | Family Medicine | 7005 Nw Beaver Dr, Johnston, IA 50131-1249 | 2012-01-12 |
| 1467683227 | Constantine Vafidis | Family Medicine | 1524 Atwood Ave Ste 225, Johnston, RI 02919-3228 | 2009-07-28 |
| 1073738902 | Danny Paul Smith | Family Medicine | 7105 Nw 70th Ave, Johnston, IA 50131-1824 | 2007-04-16 |
| 1952423469 | Matthew John Byrnes | Family Medicine | 5800 S Winwood Dr, Johnston, IA 50131-1616 | 2007-04-04 |
| 1013963818 | Jason K Austin | Family Medicine | 1524 Atwood Ave Ste 220, Johnston, RI 02919-3278 | 2006-05-25 |
| 1700846474 | Mark Edward Jones | Family Medicine | 5900 Nw 86th St Ste 100, Johnston, IA 50131-2284 | 2006-03-25 |
| 1366425274 | Iowa Physicians Clinic Medical Foundation | Family Medicine | 8101 Birchwood Ct, Suite N, Johnston, IA 50131-2930 | 2005-11-23 |
| 1366433310 | Scott R Meyer | Family Medicine | 5900 Nw 86th St, Ste 100, Johnston, IA 50131-2284 | 2005-10-31 |
| 1417958489 | Robert A Lee | Family Medicine | 5501 Nw 86th St, Suite 300, Johnston, IA 50131 | 2005-08-02 |
| Find all providers in JOHNSTON | ||||
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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.