Individual provider Active NPI

Nicole C McLaughlin, PH.D.

  • Clinical Neuropsychologist
  • Providence, RI
National Provider Identifier
1053595322
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1055 Issued in RI
Practice address
345 Blackstone Blvd
Providence, RI 02906-4800
Phone
(401) 455-0221
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1055 RI Primary
Clinical Psychologist 103TC0700X 1055 RI

Addresses

Primary practice location

345 Blackstone Blvd
Providence, RI 02906-4800

Mailing address

345 Blackstone Blvd
Providence, RI 02906-4800

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000381 RI Practitioner - Clinical Psychologist 2961564349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

455 Tollgate Rd
Warwick, RI 02886-2759

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1055RIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jul 1, 2016 Accepting new patients
Affinity Physicians LLC. Clinical Neuropsychologist CurrentSince Jul 1, 2016 Accepting new patients

Locations

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: nmclaughlin@direct.carene.org

Organizations & group practices 2

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": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1053595322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800",
            "telephone_number": "401-455-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "NICOLE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "1055",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "1055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.