Jessica Cardillo Douglas, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NPP37525 Issued in RI

Practice address

186 Providence St
West Warwick, RI 02893-2508

Phone

(401) 615-2800

Fax

(401) 615-2805

NPI assigned

Sep 3, 2009

Last updated

Jan 5, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

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.

• Thundermist Health Center

  • Federally Qualified Health Center (FQHC)
  • Wakefield, RI
  • NPI 1700041001
  Medicare reassignment NPD
• Thundermist Health Center

  • Federally Qualified Health Center (FQHC)
  • Narragansett, RI
  • NPI 1265190292
  NPD
• Thundermist Health Center

  • Federally Qualified Health Center (FQHC)
  • West Warwick, RI
  • NPI 1376708560
  NPD

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1043443385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 PROVIDENCE ST",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028932508",
            "telephone_number": "401-615-2800",
            "fax_number": "401-615-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JESSICA",
        "middle_name": "CARDILLO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "NPP37525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JD78532",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vasseur Doria Desir Kamseu, DMD
• Cayla Disano, LICSW
• Discovery House Utah (Discovery House West Warwic)
• Mei Dong, DMD
• Edward M Donnelly, MD
• Deborah Drew, CNM
• Mitzi Kim Dusin, MS, ATC
• Emerge Health and Community Services
• ER Card LLC
• Angelica Erwin, PTA

• Family Nurse Practitioner in West Warwick, RI
• Providers in West Warwick, RI by specialty
• Family Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.