PROSPECT CHARTERCARE SJHSRI, LLC (NPI# 1588089759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588089759 |
| 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 | 2014-02-25 |
| Last Update Date | 2014-11-07 |
| 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 | 251K00000X | Public Health or Welfare | Agencies | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 207R00000X | Internal Medicine | 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 |
| 1578988572 | Prospect Chartercare Sjhsri, LLC | Nutritionist | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1205364544 | Ocean State Urgent Care Center of North Providence, LLC | Internal Medicine | 1637 Mineral Spring Ave Ste 115, North Providence, RI 02904-4042 | 2017-05-31 |
| 1295083061 | Vincent Augustus Deconti | Internal Medicine | 57 West River Pkwy, North Providence, RI 02904-3430 | 2012-08-27 |
| 1316268741 | Denis E. Moonan, Md, Inc | Internal Medicine | 1515 Smith Street, Suite N, North Providence, RI 02911-2947 | 2010-06-21 |
| 1730392390 | Andrzej J Stankiewicz Md Phd Ltd | Internal Medicine | 200 High Servce Avenue, Marian Hall 2nd Floor, North Providence, RI 02904-5113 | 2007-05-08 |
| 1003940735 | Cardiology & Internal Medicine Associates of Rhode Island,inc. | Internal Medicine | 214 High Service Ave, North Providence, RI 02904-5115 | 2007-03-15 |
| 1942333877 | Amir Alizadeh,md Inc. | Internal Medicine | 1637 Mineral Spring Ave 107, North Providence, RI 02904-4042 | 2007-03-13 |
| 1386722700 | Javid A Calcatti | Internal Medicine | 1635 Mineral Spring Ave Ste 203, Suite 305, North Providence, RI 02904-4025 | 2006-11-02 |
| 1861570871 | Claude Elias Younes | Internal Medicine | 1300 Mineral Spring Ave, North Providence, RI 02904-4606 | 2006-11-01 |
| 1750475992 | Edward J Gauthier | Internal Medicine | 1332 Smith St, North Providence, RI 02911-3303 | 2006-10-03 |
| 1124095211 | Andrzej J Stankiewicz | Internal Medicine | 200 High Service Avenue, Marian Hall 2nd Floor, North Providence, RI 02904-5113 | 2006-03-07 |
| Find all providers in NORTH PROVIDENCE | ||||
| 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.