NPIMap

Organization Active NPI

St. Joseph Health Services of Ri

  • General Acute Care Hospital
  • North Providence, RI
National Provider Identifier
1013052976
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HOS00110 Issued in RI
Legal business name
ST. JOSEPH HEALTH SERVICES OF RI
Practice address
200 High Service Ave
North Providence, RI 02904-5113
Phone
(401) 456-3000
Fax
(401) 752-8248
NPI assigned
Feb 20, 2007
Reactivated
Dec 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael E Conklin Jr., CFO
Title
SNR. Vice President
Phone
(401) 456-3000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X HOS00110 RI
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X HOS00110 RI
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X HOS00110 RI
General Acute Care Hospital 282N00000X HOS00110 RI Primary

Addresses

Primary practice location

200 High Service Ave
North Providence, RI 02904-5113

Mailing address

825 Chalkstone Ave
N. Campus Business Office, Attn: R. Soares
Providence, RI 02908-4728
Phone (401) 456-2525

Other identifiers 1

IdentifierTypeStateIssuer
SJ48636MedicaidRI

Other names 1

  • WOUND CARE GROUP Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1013052976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "address_2": "N. CAMPUS BUSINESS OFFICE, ATTN: R. SOARES",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2525",
            "fax_number": "401-456-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH SERVICE AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045113",
            "telephone_number": "401-456-3000",
            "fax_number": "401-752-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HEALTH SERVICES OF RI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-12-18",
        "deactivation_date": "2007-09-19",
        "reactivation_date": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SNR. VICE PRESIDENT",
        "authorized_official_telephone_number": "401-456-3000",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "RI",
            "license": "HOS00110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SJ48636",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOUND CARE GROUP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.