MARK JAMES GAUTHIER (NPI# 1629593355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629593355 |
| Entity Type | Individual |
| Full Name | MARK JAMES GAUTHIER |
| Credential | APRRN |
| Practice Address |
75 Lambert Lind Hwy Warwick RI 02886-1131 |
| Practice Telephone | 4016814274 |
| Practice Fax Number | 4016814285 |
| Mailing Telephone | 4016814264 |
| Mailing Fax Number | 4016814285 |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-08-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN01648 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467498709 | Mark A Gauthier | Family Medicine | 1600 Highway 17 N, Surfside Beach, SC 29575-6015 | 2006-06-22 |
| Street Address |
75 LAMBERT LIND HWY |
| City | WARWICK |
| State | RI |
| Zip Code | 02886-1131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063480002 | Ethan H Kisch | Psychiatry & Neurology | 75 Lambert Lind Hwy, 120-100, Warwick, RI 02886-1131 | 2006-03-08 |
| 1205311065 | Maria Anna Guirguis | Pharmacist | 75 Lambert Lind Hwy, Warwick, RI 02886-1131 | 2018-09-27 |
| 1700306552 | Rebecca Swagger | Counselor | 75 Lambert Lind Hwy, Warwick, RI 02886-1131 | 2017-06-22 |
| 1720528557 | Amanda Grandchamp | Counselor | 75 Lambert Lind Hwy, Suite 120-100, Warwick, RI 02886-1131 | 2017-02-27 |
| 1184179814 | Darryle Steinberg | Registered Nurse | 75 Lambert Lind Hwy, Warwick, RI 02886-1131 | 2016-08-23 |
| 1871957688 | Tanya Plamondon | Marriage & Family Therapist | 75 Lambert Lind Hwy, Suite 120-100, Warwick, RI 02886-1131 | 2016-04-07 |
| 1487039863 | Brian Lalli | Counselor | 75 Lambert Lind Hwy, Suite 120-100, Warwick, RI 02886-1131 | 2015-07-27 |
| 1790183069 | Stephanie Rickerman | Nurse Practitioner | 75 Lambert Lind Hwy, Suite 120-100, Warwick, RI 02886-1131 | 2014-12-18 |
| 1659792778 | Carla May Rich | Counselor | 75 Lambert Lind Hwy, Warwick, RI 02886-1131 | 2013-12-16 |
| 1285070383 | Nina Ackmann | Social Worker | 75 Lambert Lind Hwy, Suite 120-100, Warwick, RI 02886-1131 | 2013-05-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528694445 | Sheri Lynn Sklarz | Specialist | 300 Quaker Lane, Miracle Ear Suite C15, Warwick, RI 02886 | 2020-03-23 |
| 1316581424 | Dr. Degiulio & Associates Inc | Optometrist | 400 Bald Hill Road Ste 163, Warwick Mall, Warwick, RI 02886 | 2019-10-31 |
| 1255813291 | Samantha Pena Moore | Behavioral Analyst | 3446 Post Road, Warwick, RI 02886 | 2018-09-06 |
| 1912496209 | Martin Jude Cotti | Internal Medicine | 455 Toll Gate Rd., Warwick, RI 02886 | 2018-05-02 |
| 1447764261 | Cynthia A Lessard | Nurse Practitioner | 15 Health Lane, Warwick, RI 02886 | 2017-12-01 |
| 1538687520 | David A. Bennett | Registered Nurse | 2756 Post Road, Warwick, RI 02886 | 2017-08-30 |
| 1427585223 | Brittany Teixeira | Counselor | 85 Earl Street, Warwick, RI 02886 | 2017-05-11 |
| 1497125199 | Aiden Philip Cwynar | Optometrist | 1050 Centerville Road, Warwick, RI 02886 | 2015-10-07 |
| 1104221738 | Wilfredo L Sancianco Dmd Inc | Preferred Provider Organization | 3411 W Shiore Rd, Warwick, RI 02886 | 2014-10-24 |
| 1831508662 | Matthew Bryant Mitchell | Physical Therapist | 400 Bald Hill Rd #511, Warwick, RI 02886 | 2014-08-06 |
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| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215562566 | Katie Elizabeth Thayer | Nurse Practitioner | 300 Centerville Rd Ste 101, Warwick, RI 02886-0200 | 2020-03-06 |
| 1922356724 | Susan Jane Perry | Nurse Practitioner | 469 Centerville Rd., Suite 103, Warwick, RI 02886-4342 | 2012-08-27 |
| 1063417855 | Janice Elena Archer | Nurse Practitioner | 60 Merrymount Dr, Warwick, RI 02888-5525 | 2005-06-17 |
| 1902442874 | Raissa Mutuyimana | Nurse Practitioner | 300 Quaker Ln # C2-4, Warwick, RI 02886-0159 | 2019-11-26 |
| 1538522578 | Agape Counsiling Center Janice Archeer Sole Mbr | Nurse Practitioner | 60 Merrymount Dr, Warwick, RI 02888-5525 | 2016-03-29 |
| 1790183069 | Stephanie Rickerman | Nurse Practitioner | 75 Lambert Lind Hwy, Suite 120-100, Warwick, RI 02886-1131 | 2014-12-18 |
| 1609277094 | James Pollard IIi | Nurse Practitioner | 455 Toll Gate Rd, Warwick, RI 02886-2759 | 2014-09-04 |
| 1043260268 | Cathy Lynn Kennedy | Nurse Practitioner | 2756 Post Rd, Attn: Billing Office, Warwick, RI 02886-3003 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540042 | North Road Psychiatry LLC | Nurse Practitioner | 23 North Rd Ste A11, Peace Dale, RI 02879-8108 | 2020-08-31 |
| 1750992319 | Katherine Elizabeth Loffredo | Nurse Practitioner | 74 Seymour St, Warren, RI 02885-4227 | 2020-08-16 |
| 1174149686 | Goldline Health and Wellness LLC | Nurse Practitioner | 750 East Ave Lowr Level, Pawtucket, RI 02860-6245 | 2020-06-20 |
| 1477197820 | Jaron Keough | Nurse Practitioner | 232 Pawtucket Ave Apt 1, Pawtucket, RI 02860-5169 | 2019-10-29 |
| 1538622394 | Partners In Psychiatry LLC | Nurse Practitioner | 1525 Old Louisquisset Pike Ste B203, Lincoln, RI 02865-4522 | 2019-04-09 |
| 1356819908 | Kellie Ferrie | Nurse Practitioner | 250 Wampanoag Trl Ste 302, Riverside, RI 02915-2217 | 2018-11-12 |
| 1306326202 | Samuel David Kaufman | Nurse Practitioner | 34 Rice Ave, E Providence, RI 02914-3147 | 2018-08-20 |
| 1205350980 | Tabitha Ann Imondi | Nurse Practitioner | 1525 Old Louisquisset Pike Ste 203, Lincoln, RI 02865-4503 | 2017-08-03 |
| 1366983314 | Alyssa Pullan | Nurse Practitioner | 78 Courtney Ave, Pawtucket, RI 02861-3935 | 2017-03-10 |
| 1861944969 | Innovative Therapeutics of Rhode Island LLC | Nurse Practitioner | 316 Willett Ave, Riverside, RI 02915-2511 | 2016-10-25 |
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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.