THUNDERMIST HEALTH CENTER (NPI# 1700041001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700041001 |
| Entity Type | Organization |
| Organization Name | THUNDERMIST HEALTH CENTER |
| Practice Address |
1 River St Wakefield RI 02879-3214 |
| Mailing Address |
171 Service Ave Ste 330 Warwick RI 02886-1015 |
| Practice Telephone | 4017830523 |
| Practice Fax Number | 4017839448 |
| Mailing Telephone | 4017674100 |
| Mailing Fax Number | 4012356833 |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2019-06-06 |
| Authorized Official Name | CKARLA AGUDELO (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 4017674100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | ACF01566 | RI | Agencies |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
ACF01566 | RI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 4101805 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056830 | Thundermist Health Center | Clinic/Center | 450 Clinton St, Woonsocket, RI 02895-3207 | 2020-09-02 |
| 1801152947 | Thundermist Health Center | Community/Behavioral Health | 777 Cass Ave, High School Health Clinic, Woonsocket, RI 02895-4719 | 2012-04-03 |
| 1376708560 | Thundermist Health Center | Community/Behavioral Health | 186 Providence St, West Warwick, RI 02893-2508 | 2008-07-28 |
| 1457522989 | Thundermist Health Center | Clinic/Center | 25 John A Cummings Way, Woonsocket, RI 02895-3244 | 2008-03-12 |
| 1588691620 | Thundermist Health Center | Peer Specialist | 450 Clinton St, Woonsocket, RI 02895-3207 | 2006-06-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THUNDERMIST HEALTH CENTER SOUTH COUNTY | 450 Clinton St, Woonsocket, RI 02895-3207 |
| Street Address |
1 RIVER ST |
| City | WAKEFIELD |
| State | RI |
| Zip Code | 02879-3214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104805431 | La Shun La Rue Carroll | Dentist | 1 River St, Wakefield, RI 02879-3214 | 2006-01-13 |
| 1245856814 | Amanda Mchugh | Student in an Organized Health Care Education/Training Program | 1 River St, Wakefield, RI 02879-3214 | 2020-06-19 |
| 1104440965 | Jeffrey W Bouley | Nurse Practitioner | 1 River St, Wakefield, RI 02879-3214 | 2020-06-07 |
| 1881223394 | Nickesha Romaine Mckenzie | Registered Nurse | 1 River St, Wakefield, RI 02879-3214 | 2020-04-06 |
| 1982234076 | Phoebe F Hall | Nurse Practitioner | 1 River St, Wakefield, RI 02879-3214 | 2020-01-17 |
| 1871140392 | Abby Kolb Landers | Registered Nurse | 1 River St, Wakefield, RI 02879-3214 | 2019-08-20 |
| 1912550054 | Marie Olivette Martin | Nurse Practitioner | 1 River St, Wakefield, RI 02879-3214 | 2019-07-18 |
| 1740832922 | Emily Lauren Benson | Dentist | 1 River St, Wakefield, RI 02879-3214 | 2019-07-09 |
| 1104308204 | Virginia Curtis | Nurse Practitioner | 1 River St, Wakefield, RI 02879-3214 | 2018-09-05 |
| 1831683432 | Olivia Macaskill | Nurse Practitioner | 1 River St, Wakefield, RI 02879-3214 | 2018-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831549435 | Bh Brightview Commons Opco, LLC | Alzheimer Center (Dementia Center) | 57 Grandeville Court, Wakefield, RI 02879 | 2016-06-15 |
| 1215392071 | Leslie Healy | Occupational Therapist | 12 Galleon Ct, Wakefield, RI 02879 | 2015-12-22 |
| 1649673799 | Peter Storti | Clinic/Center | 28 Columbia Street, Wakefield, RI 02879 | 2014-10-03 |
| 1285988790 | Silver Spring Health Care Management, Inc. | Physician Assistant | 70 Kenyon Ave Unit 321, Wakefield, RI 02879 | 2012-11-06 |
| 1013271584 | Amy Lee Barker | Speech-Language Pathologist | 213 Robinson Street, Wakefield, RI 02879 | 2012-06-29 |
| 1366708489 | Paige Houlihan | Student in an Organized Health Care Education/Training Program | 91 Rocky Brook Way St, Wakefield, RI 02879 | 2012-04-03 |
| 1639307176 | Perspectives Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 53 Dockray Street, Wakefield, RI 02879 | 2009-06-23 |
| 1649482233 | Marilyn A. Cooney | Speech-Language Pathologist | 307 Curtis Corner Road, Wakefield, RI 02879 | 2007-05-04 |
| 1518184522 | Keeley Therese Dante-card | Registered Nurse | 55 Cherry Lane, Wakefield, RI 02879 | 2007-04-19 |
| 1679799217 | Codac Inc | Peer Specialist | 350 Columbia St, Codac South County, Wakefield, RI 02879 | 2007-04-18 |
| Find all providers in zip 02879 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1003362864 | Northwest Community Health Care | Clinic/Center | 35 Village Plaza Way, 1-53 Village Plaza Way, Units 12 & 13, Scituate, RI 02857-1849 | 2016-08-31 |
| 1760532451 | Narragansett Indian Tribe | Clinic/Center | 51 Old Mill Rd, Charlestown, RI 02813-3322 | 2007-01-12 |
| 1861439705 | East Bay Community Action Program | Clinic/Center | 19 Broadway, Newport, RI 02840-2937 | 2006-05-31 |
| 1174576342 | The Providence Community Health Centers, Inc. | Clinic/Center | 1 Warren Way, Providence, RI 02905-5000 | 2006-05-18 |
| 1821090358 | The Providence Community Health Centers, Inc. | Clinic/Center | 100 Curtis St, Providence, RI 02909-3623 | 2005-08-15 |
| 1295737666 | The Providence Community Health Centers, Inc. | Clinic/Center | 325 Public St, Providence, RI 02905-2340 | 2005-08-15 |
| 1669474102 | The Providence Community Health Centers, Inc. | Clinic/Center | 40 Candace St, Providence, RI 02908-3747 | 2005-08-15 |
| 1053313593 | The Providence Community Health Centers, Inc | Clinic/Center | 375 Allens Ave, Providence, RI 02905-5010 | 2005-08-15 |
| 1508868035 | The Providence Community Health Centers, Inc. | Clinic/Center | 239 Cranston St, Providence, RI 02907-2406 | 2005-08-15 |
| 1417959867 | The Providence Community Health Centers, Inc | Clinic/Center | 355 Prairie Ave, Providence, RI 02905-5010 | 2005-08-15 |
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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.