NPIMap

Individual provider Active NPI

Courtney Clark Bilodeau, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1013109891
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD12427 Issued in RI
Practice address
146 West River Street
3Rd Floor
Providence, RI 02904
Phone
(401) 793-5700
Fax
(401) 793-7801
NPI assigned
Aug 15, 2007
Last updated
Feb 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD12427 RI Primary

Addresses

Primary practice location

146 West River Street
3Rd Floor
Providence, RI 02904

Mailing address

146 West River Street
3Rd Floor
Providence, RI 02904
Phone (401) 793-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071116000488 RI Practitioner - Internal Medicine 0547358046 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

245 Chapman St
Suite 300
Providence, RI 02905-4539
Phone (401) 444-5280

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD12427RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Sep 21, 2024 Accepting new patients
The Miriam Hospital CurrentSince Aug 1, 2011 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Oct 1, 2014 Accepting new patients
The Miriam Hospital CurrentSince Aug 1, 2011 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Oct 1, 2014 Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital Current Accepting new patients
Rhode Island Hospital CurrentSince Sep 21, 2024 Accepting new patients
Women & Infants Hospital of Rhode Island Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

146 W River St
Fl 3
Providence, RI 02904
Phone (401) 793-5700

146 W River St
Ste 11C
Providence, RI 02904
Phone (401) 606-3000

148 W River St
Ste 8
Providence, RI 02904
Phone (401) 606-3000

245 Chapman St
Ste 300
Providence, RI 02905
Phone (401) 444-4741

593 Eddy St
Providence, RI 02903

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1013109891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 WEST RIVER STREET",
            "address_2": "3RD FLOOR",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-793-5700",
            "fax_number": "401-793-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 WEST RIVER STREET",
            "address_2": "3RD FLOOR",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-793-5700",
            "fax_number": "401-793-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK BILODEAU",
        "first_name": "COURTNEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD12427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.