Individual provider Active NPI

Mary Elizabeth Glasheen Murray, MD

  • Pediatrics Physician
  • South Kingstown, RI
National Provider Identifier
1013943240
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
8114 Issued in RI
Practice address
65 Village Square Dr
Suite 101
South Kingstown, RI 02879-2292
Phone
(401) 789-5924
Fax
(401) 782-1770
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 8114 RI Primary

Addresses

Primary practice location

65 Village Square Dr
Suite 101
South Kingstown, RI 02879-2292

Mailing address

10 Davol SQ
Suite 400
Providence, RI 02903-4754
Phone (401) 421-4000

Other identifiers 4

IdentifierTypeStateIssuer
1903OtherRINEIGHBORHOOD HTH PLAN
710054401OtherCIGNA
1200296OtherUNITED HEALTH
MM06965MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmurray220852@direct.lifespan.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110415000117 RI Practitioner - Pediatric Medicine 4284818220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8114RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Pediatrics CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Apr 25, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

900 Warren Ave
Ste 200
East Providence, RI 02914
Phone (401) 421-6481

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

65 Village Square Dr
Ste 101
Wakefield, RI 02879
Phone (401) 789-5924

Interoperability endpoints

  • Direct secure messaging: mmurray220852@brownhealth.medalliesdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1013943240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ",
            "address_2": "SUITE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR",
            "address_2": "SUITE 101",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792292",
            "telephone_number": "401-789-5924",
            "fax_number": "401-782-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "MARY ELIZABETH",
        "middle_name": "GLASHEEN",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "8114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HTH PLAN",
            "identifier": "1903",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "710054401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "1200296",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MM06965",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmurray220852@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "65 Village Square Dr",
            "address_2": "Suite 101",
            "city": "South Kingstown",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028792292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Kingstown, RI

Sources for this page

Verify at the official NPI Registry.