Active NPI
John Urban, MD
- Cardiovascular Disease Physician
- Providence, RI
National Provider Identifier
1023090982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD04558
- Practice address
- 120 Dudley St
Suite 204
Providence, RI 02905-2436 - Phone
- (401) 421-7486
- Fax
- (401) 421-4150
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MD04558 | RI | Primary |
Addresses
Primary practice location
120 Dudley St
Suite 204
Providence, RI 02905-2436
Mailing address
120 Dudley St
Suite 204
Providence, RI 02905-2436
Phone (401) 421-7486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9001617 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD04558 | RI | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023090982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 DUDLEY ST",
"address_2": "SUITE 204",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029052436",
"telephone_number": "401-421-7486",
"fax_number": "401-421-4150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 DUDLEY ST",
"address_2": "SUITE 204",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029052436",
"telephone_number": "401-421-7486",
"fax_number": "401-421-4150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URBAN",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "RI",
"license": "MD04558",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9001617",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.