Courtney Clark Bilodeau, MD
Individual provider Active NPI Internal Medicine Physician · Providence, RI
NPI 1013109891 · NPPES record last updated Feb 3, 2012
Key facts
- NPI
- 1013109891
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD12427 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rhode Island Hospital
Lifespan Physician Group Inc
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
- Rhode Island Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071116000488 | RI | Practitioner - Internal Medicine | 0547358046 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD12427 | RI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Miriam Hospital | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current |
Accepting new patients | |
| Rhode Island Hospital | Current |
Accepting new patients | |
| Lifespan Physician Group, Inc. | Current |
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 | Current |
Accepting new patients | |
| The Miriam Hospital | Current |
Accepting new patients | |
| Rhode Island Hospital | Past | Accepting new patients | |
| Lifespan Physician Group, Inc. | Past | Accepting new patients | |
| Women & Infants Hospital of Rhode Island | 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
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
146 W River St
Ste 11C
Providence, RI 02904
Phone (401) 606-3000
593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280
593 Eddy St
Providence, RI 02903
101 Dudley St
Providence, RI 02905
Phone (401) 453-7950
146 W River St
Fl 3
Providence, RI 02904
Phone (401) 793-5700
245 Chapman St
Ste 300
Providence, RI 02905
Phone (401) 444-4741
148 W River St
Ste 8
Providence, RI 02904
Phone (401) 606-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD12427 | RI | Yes |
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
Other providers in Providence, RI
- Brittany Ciullo
- Kristina Clairborne
- Debra J. Clancy
- Samantha L Clapper
- Erin Melissa Clare Sears
- Lindsay Erin Clark Donat
- Melanie Beth Clark-Medyesy
- Aimee Elizabeth Clark
- Clara Clark
- Jevin Clark
All providers in Providence, RI · Internal Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.