PROSPECT CHARTERCARE SJHSRI, LLC (NPI# 1578988572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578988572 |
| Entity Type | Organization |
| Organization Name | PROSPECT CHARTERCARE SJHSRI, LLC |
| Other Organization Name | OUR LADY OF FATIMA HOSPITAL |
| Practice Address |
200 High Service Ave North Providence RI 02904-5113 |
| Practice Telephone | 4014563000 |
| Practice Fax Number | 4014563028 |
| Mailing Telephone | 4014563000 |
| Mailing Fax Number | 4014563028 |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-06-26 |
| Authorized Official Name | ELLEN SHIN (SECRETARY) |
| Authorized Official Telephone | 3109434520 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Our Lady of Fatima Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821656034 | Prospect Chartercare Sjhsri, LLC | Internal Medicine | 200 High Service Ave, N Providence, RI 02904-5113 | 2019-06-03 |
| 1639584717 | Prospect Chartercare Sjhsri, LLC | Dentist | 21 Peace St, Providence, RI 02907-1510 | 2014-06-26 |
| 1205251204 | Prospect Chartercare Sjhsri, LLC | Rehabilitation Unit | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1871918870 | Prospect Chartercare Sjhsri, LLC | General Acute Care Hospital | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1396160396 | Prospect Chartercare Sjhsri, LLC | Psychiatric Unit | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1588089759 | Prospect Chartercare Sjhsri, LLC | Public Health or Welfare | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-25 |
| Street Address |
200 HIGH SERVICE AVE |
| City | NORTH PROVIDENCE |
| State | RI |
| Zip Code | 02904-5113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730179607 | James D Sullivan | Emergency Medicine | 200 High Service Ave, North Providence, RI 02904-5113 | 2005-10-24 |
| 1023628385 | Jona Volcy | Social Worker | 200 High Service Ave, North Providence, RI 02904-5113 | 2020-08-03 |
| 1437770625 | Shana Rose Libassi | Physician Assistant | 200 High Service Ave, North Providence, RI 02904-5113 | 2020-04-29 |
| 1447886171 | Kaylee Joy Taillon | Physician Assistant | 200 High Service Ave, North Providence, RI 02904-5113 | 2020-03-13 |
| 1528619772 | Christine Mary Merloni | Technician/Technologist | 200 High Service Ave, North Providence, RI 02904-5113 | 2019-09-27 |
| 1740748235 | Daniel Michael Leary | Physician Assistant | 200 High Service Ave, North Providence, RI 02904-5113 | 2019-03-04 |
| 1366913873 | Ainsley King Parker | Social Worker | 200 High Service Ave, North Providence, RI 02904-5113 | 2018-12-10 |
| 1093285751 | Jennifer Lynn Deblois | Dietitian, Registered | 200 High Service Ave, North Providence, RI 02904-5113 | 2018-11-26 |
| 1972081966 | Melissa Ann Mcgovern | Physician Assistant | 200 High Service Ave, North Providence, RI 02904-5113 | 2018-08-01 |
| 1285147702 | Jean Yeomans | Social Worker | 200 High Service Ave, North Providence, RI 02904-5113 | 2017-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144792383 | Lifespan Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 180 Corliss Street, Suite A, Providence, RI 02904 | 2018-12-28 |
| 1780168229 | Beth M. Kalunian | Social Worker | 480 Charles Street, Providence, RI 02904 | 2018-09-20 |
| 1588161608 | Michael P. Johnson, Md, Inc | Internal Medicine | 148 W River St Ste 22b, Providence, RI 02904 | 2018-04-06 |
| 1780045948 | Fred Saccoccio | Pharmacist | 15 Smithfield Road, No Providence, RI 02904 | 2016-03-16 |
| 1699148999 | Latin Adult Day Health Care Center | Clinic/Center | 665 Charles Street, Providence, RI 02904 | 2015-11-09 |
| 1144639956 | Dina P Toolin | Occupational Therapist | 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 | 2014-08-06 |
| 1801208798 | Seth Clark | Internal Medicine | 200 Corliss St, Providence, RI 02904 | 2014-05-27 |
| 1134554645 | Molly Elizabeth Smith | Physical Therapist | 1405 Douglas Ave, North Providence, RI 02904 | 2013-09-04 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| 1598036790 | Joseph F. Osmanski, Od, Inc | Optometrist | 1971 Mineral Spring Avenue, N. Providence, RI 02904 | 2012-01-19 |
| Find all providers in zip 02904 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083636674 | Joseph A Farina | Internal Medicine | 185a High Service Ave, North Providence, RI 02904-5114 | 2006-07-24 |
| 1841335775 | St. Joseph Health Services of Ri | Internal Medicine | 200 High Service Ave, North Providence, RI 02904-5113 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336381904 | Michael Wu | Internal Medicine | 950 Warren Ave Ste 201, East Providence, RI 02914-1432 | 2009-03-29 |
| 1902052558 | T.w. Tschirley Md Inc | Internal Medicine | 1524 Atwood Ave Ste 434, Johnston, RI 02919-3228 | 2008-08-14 |
| 1427210251 | John Rodriguez | Internal Medicine | 68 Cumberland St Ste 103, Woonsocket, RI 02895 | 2008-07-02 |
| 1689836371 | Katharine A. French | Internal Medicine | 950 Warren Ave Fl 2, East Providence, RI 02914-1432 | 2008-06-25 |
| 1265621460 | Gideon Koren | Internal Medicine | Rih, 1 Hoppin Street, Providence, RI 02903 | 2007-10-24 |
| 1134315567 | David B Pomfret | Internal Medicine | 20 Grey Gull Rd, Jamestown, RI 02835-2808 | 2007-09-19 |
| 1679792865 | Kenneth Baxter Nanian | Internal Medicine | 201 Tanglewood Dr, East Greenwich, RI 02818-2215 | 2007-04-25 |
| 1417085622 | Laboratorio Cardiovascular De P.r. | Internal Medicine | 391 Sargento Luis Medina Street, La Merced, San Juan, RI 00918 | 2007-03-01 |
| 1003921693 | Mario Tami | Internal Medicine | 1264 Smith St, Providence, RI 02908 | 2006-08-21 |
| 1205942646 | David J Fortunato | Internal Medicine | 75 S Union St, Unit 406, Pawtucket, RI 02860-3978 | 2006-08-21 |
| Find all providers with the same taxonomy | ||||
| City | NORTH PROVIDENCE |
| Zip Code | 02904 |
Please comment or provide details below to improve the information on PROSPECT CHARTERCARE SJHSRI, LLC.
| 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.