Jeffrey M Wilson (NPI# 1134113749, PAC ID# 2769433945) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1134113749 |
PAC ID by PECOS | 2769433945 |
Professional Enrollment ID | I20050204000337 |
Full Name | Jeffrey M Wilson |
Organization Legal Name | FAMILY HEALTH AND SPORTS MEDICINE LLC |
Address |
65 Sockanosset Cross Rd Suite 301 Cranston RI 02920-5536 |
Phone Number | 4019436910 |
Gender | M |
Credential | MD |
Medical School | HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE |
Graduation Year | 1998 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 4789809591 |
Number of Group Practice Members | 4 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
410005 | OUR LADY OF FATIMA HOSPITAL |
410012 | THE MIRIAM HOSPITAL |
410009 | KENT COUNTY MEMORIAL HOSPITAL |
Address | Phone | Organization |
---|---|---|
65 Sockanosset Cross Rd, Suite 301, Cranston, RI 02920-5536 | 4019436910 | FAMILY HEALTH AND SPORTS MEDICINE LLC |
Organization Legal Name | FAMILY HEALTH AND SPORTS MEDICINE LLC |
Physicians | 4 |
Name | Specialty | Organization | Address |
---|---|---|---|
Mark Rosenberg | Family Medicine | Family Health and Sports Medicine LLC | 65 Sockanosset Cross Rd, Suite 301, Cranston, RI 02920-5536 |
David Anthony Interlini | Physician Assistant | Family Health and Sports Medicine LLC | 65 Sockanosset Cross Rd, Suite 301, Cranston, RI 02920-5536 |
Albert J Puerini Jr. | Family Practice | Family Health and Sports Medicine LLC | 65 Sockanosset Cross Rd, Suite 301, Cranston, RI 02920-5536 |
Street Address |
65 SOCKANOSSET CROSS RD SUITE 301 |
City | CRANSTON |
State | RI |
Zip | 02920-5536 |
Name | Specialty | Organization | Address |
---|---|---|---|
Mark Rosenberg | Family Medicine | Family Health and Sports Medicine LLC | 65 Sockanosset Cross Rd, Suite 301, Cranston, RI 02920-5536 |
Earle O Assanah | Interventional Radiology | X Ray Associates, Inc | 65 Sockanosset Cross Rd, Cranston, RI 02920-5536 |
David Anthony Interlini | Physician Assistant | Family Health and Sports Medicine LLC | 65 Sockanosset Cross Rd, Suite 301, Cranston, RI 02920-5536 |
Sarah-kim Shields | Diagnostic Radiology | X Ray Associates, Inc | 65 Sockanosset Cross Rd, Cranston, RI 02920-5536 |
John J Stanley | Diagnostic Radiology | X Ray Associates, Inc | 65 Sockanosset Cross Rd, Cranston, RI 02920-5536 |
Rolina Levin | Diagnostic Radiology | X Ray Associates, Inc | 65 Sockanosset Cross Rd, Cranston, RI 02920-5536 |
Daniel L Druckman | Diagnostic Radiology | X Ray Associates, Inc | 65 Sockanosset Cross Rd, Cranston, RI 02920-5536 |
Charles M Rosenthal | Diagnostic Radiology | X Ray Associates, Inc | 65 Sockanosset Cross Rd, Cranston, RI 02920-5536 |
Albert J Puerini Jr. | Family Practice | Family Health and Sports Medicine LLC | 65 Sockanosset Cross Rd, Suite 301, Cranston, RI 02920-5536 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kathleen Salisbury | Physician Assistant | Coastal Medical Inc | 75 Sockanosset Xrd, Suite 100, Cranston, RI 02920 |
Susan Parker | Physical Therapy | Excel Physical Therapy Inc | 51 Sockanosset Xrd, Cranston, RI 02920 |
G. Miles Mullervy | Clinical Social Worker | 75 Sockanosset Xrds, Suite 206, Cranston, RI 02920 | |
Mario Santomassimo | Physical Therapy | Excel Physical Therapy Inc | 51 Sockanosset Xrd, Cranston, RI 02920 |
Edward Mccormick | Physical Therapy | Excel Physical Therapy Inc | 51 Sockanosset Xrd, Cranston, RI 02920 |
Karen H Stevenson | Internal Medicine | Coastal Medical Inc | 75 Sockanosset Xrd, Suite 100, Cranston, RI 02920 |
Kathryn O Coolidge | Internal Medicine | Coastal Medical Inc | 75 Sockanosset Xrd, Suite 100, Cranston, RI 02920 |
Yul D Ejnes | Internal Medicine | Coastal Medical Inc | 75 Sockanosset Xrd, Suite 100, Cranston, RI 02920 |
Kimberly A Propert | Nurse Practitioner | Coastal Medical Inc | 75 Sockanosset Xrd, Suite 100, Cranston, RI 02920 |
Patrick George Lachut | Physical Therapy | Excel Physical Therapy Inc | 51 Sockanosset Xrd, Cranston, RI 02920 |
Find all physicians in zip 02920 |
City | CRANSTON |
Zip Code | 02920 |
Specialty | FAMILY MEDICINE |
City + Specialty | CRANSTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jeffrey M Wilson.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.