PVD Cares Wellness Center LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PVD CARES WELLNESS CENTER LLC

Practice address

126 Prospect St Ste 105
Pawtucket, RI 02860-4429

Phone

(401) 753-2526

Fax

(401) 235-4152

NPI assigned

Dec 5, 2019

Last updated

Jun 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Effien King, FNPNPI 1518511021

Title

Nurse Practitioner

Phone

(323) 770-6210

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI, CA, AZ3 enrollments

Enrollment records 3

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Effien King, FNP

  • Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
  • Pawtucket, RI
  • NPI 1518511021

  AZ, CA, Single Specialty

  Medicare reassignment NPD Authorized official
• Lissa Pierre, FNP-C

  • Family Nurse Practitioner
  • North Providence, RI
  • NPI 1346013661
  Medicare reassignment NPD
• Michele Bailey Chaudhry

  • Clinical Social Worker
  • Cranston, RI
  • NPI 1134250715
  NPD (past)
• Horatio Pearson, RN

  • Registered Nurse
  • Pawtucket, RI
  • NPI 1669380259
  NPD (past)
• David Tulli, LICSW

  • Clinical Social Worker
  • Warwick, RI
  • NPI 1487775573
  NPD (past)
• Christie Wilson, LMFT

  • Marriage & Family Therapist
  • Riverside, RI
  • NPI 1548473796
  NPD (past)
• Lisa Wilson, LCSW

  • Clinical Social Worker
  • Warwick, RI
  • NPI 1952560872
  NPD (past)

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1063059244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 PROSPECT ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604476",
            "telephone_number": "401-753-2526",
            "fax_number": "401-235-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 PROSPECT ST STE 105",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604429",
            "telephone_number": "401-753-2526",
            "fax_number": "401-235-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PVD CARES WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "EFFIEN",
        "authorized_official_title_or_position": "NURSE  PRACTITIONER",
        "authorized_official_telephone_number": "323-770-6210",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Psych Solutions LLC
• Chan Yeu Pu, M.D.
• Alyssa Pullan, PMHNP-BC
• Tatiana Pullar, BCBA
• PVD Cares Psychiatry LLC
• Quick Clever Care Inc
• Cara Quinn, LMFT
• Toni Quinn, LMHC
• Reema Qureshi, M.D.
• R.I. Colorectal Clinic 1, LLC

• Nurse Practitioner in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.