JACK R WANDS (NPI# 1689614703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689614703 |
| Entity Type | Individual |
| Full Name | JACK R WANDS |
| Credential | MD |
| Practice Address |
375 Wampanoag Trl Suite 202a Riverside RI 02915-2232 |
| Mailing Address |
17 Virginia Ave Suite 107 Providence RI 02905-4406 |
| Practice Telephone | 4016494030 |
| Practice Fax Number | 4016494031 |
| Mailing Telephone | 4014434992 |
| Mailing Fax Number | 4017844902 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD09974 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 9002756 | 05 |
| Street Address |
375 WAMPANOAG TRL SUITE 202A |
| City | RIVERSIDE |
| State | RI |
| Zip Code | 02915-2232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417955071 | Marina F Rodriguez | Internal Medicine | 375 Wampanoag Trl, Suite 201, Riverside, RI 02915-2212 | 2005-07-08 |
| 1235789231 | Maxwell Hogue | Nurse Practitioner | 375 Wampanoag Trl, Riverside, RI 02915-2232 | 2019-09-12 |
| 1114574860 | Lindsey Harris | Physical Therapist | 375 Wampanoag Trl, Riverside, RI 02915-2232 | 2019-08-19 |
| 1447713680 | Kate M Guthrie | Psychologist | 375 Wampanoag Trl, Riverside, RI 02915-2232 | 2019-04-12 |
| 1386159069 | Aletheia Yuri Miyake Shen | Nurse Practitioner | 375 Wampanoag Trl, Riverside, RI 02915-2232 | 2017-12-04 |
| 1699223404 | Silver Fern Practice, LLC | Physical Therapist | 375 Wampanoag Trl, Suite 403, Riverside, RI 02915-2232 | 2016-09-21 |
| 1528433489 | Cerissa Blaney | Psychologist | 375 Wampanoag Trl, Riverside, RI 02915-2232 | 2015-12-03 |
| 1205231081 | Mary Whittenhall | Nurse Practitioner | 375 Wampanoag Trl, Suite 302b, Riverside, RI 02915-2232 | 2014-10-23 |
| 1649602863 | Amanda J. Fernandes | Internal Medicine | 375 Wampanoag Trl, Riverside, RI 02915 | 2013-07-30 |
| 1861749327 | Laura A. Massa | Nurse Practitioner | 375 Wampanoag Trl, Suite 202a, Riverside, RI 02915-2232 | 2012-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881101335 | Brown Medicine | Clinic/Center | 62-68 Amaral Street, East Providence, RI 02915 | 2018-01-05 |
| 1093245391 | Robyn Lee Cranson | Pharmacist | 1086 Willet Ave, Rite Aid Pharmacy, Riverside, RI 02915 | 2017-06-19 |
| 1548703622 | Rebecca Leigh Bejma | Registered Nurse | 100 Bullocks Ave, East Providence, RI 02915 | 2016-11-22 |
| 1568833408 | Riverside Smiles Theodore I Goldberg, Dmd PC & Associates | Dentist | 250 Wampanoag Trail Suite 103, Riverside, RI 02915 | 2015-10-19 |
| 1003165796 | Sandra Cairo | Registered Nurse | 125 Bayview Ave, Riverside, RI 02915 | 2012-09-10 |
| 1487916136 | East Bay Community Action Program | Peer Specialist | 100 Bullocks Point, Riverside, RI 02915 | 2012-06-08 |
| 1497041453 | Bethany Marie Goldberg | Nurse Practitioner | 38 Amaral Street, Riverside, RI 02915 | 2011-06-28 |
| 1790078947 | Matthew Lynch | Internal Medicine | 375 Wampanoag Trl Ste 302a, Riverside, RI 02915 | 2011-05-20 |
| 1679866206 | Jill Stone | Occupational Therapist | 57 Euclid Ave, East Providence, RI 02915 | 2011-05-16 |
| 1770884462 | Kristin F. Cadieux | Nurse Practitioner | 375 Wampanoag Trl Ste 102, Riverside, RI 02915 | 2010-11-11 |
| Find all providers in zip 02915 | ||||
| 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 |
|---|---|---|---|---|
| 1538768064 | Express Carenow, Inc | Internal Medicine | 4100 Central Ave Ste 101, Riverside, CA 92506-2930 | 2020-10-26 |
| 1073136495 | Lydia Alejandra Robles Gomez | Internal Medicine | 3722 S Harlem Ave, Macneal Center for Internal Medi, Suite Ll 34, Riverside, IL 60546 | 2020-05-20 |
| 1770105611 | Amala Chacko | Internal Medicine | 3722 South Harlem Ave, Macneal Center for Internal Medicine, Riverside, IL 60546 | 2020-05-14 |
| 1982225173 | Aneurin Cornolius Fernandez | Internal Medicine | 3722 South Harlem Ave Suite Ll34, Macneal Center for Internal Medicine, Riverside, IL 60546 | 2020-04-29 |
| 1477113264 | Amulya Reddy Kasireddy | Internal Medicine | 3722 South Harlem Macneal Center for Internal Meidicine, Suite Ll34, Riverside, IL 60546 | 2019-06-14 |
| 1336702927 | Shelden Selas Rodrigues | Internal Medicine | Macneal Center for Internal Medicine 3722 South Harlem, Suite Ll34, Riverside, IL 60546 | 2019-04-18 |
| 1083277685 | Hasrat Sidhu | Internal Medicine | 3722 South Harlem Ave., Macneal Center for Internal Med, Suite Ll34, Riverside, IL 60546 | 2019-04-18 |
| 1336639426 | Daniele Sebastiano Restifo Ortega | Internal Medicine | Macneal Center for Internal Medicine, 3722 South Harlem Ave Suite Ll34, Riverside, IL 60546 | 2018-05-14 |
| 1699263632 | Diana Alexandra Kreppel | Internal Medicine | 3722 South Harlem Avenue Macneal Center for Internal Me, Suite Ll34, Riverside, IL 60546 | 2018-04-25 |
| 1134626690 | Fanny Vanessa Giron Galeano | Internal Medicine | 3722 South Harlem Ave Macneal Center for Internal Medic, Suite Ll34, Riverside, IL 60546 | 2018-04-11 |
| Find all providers in RIVERSIDE | ||||
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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.