NPIMap

Organization Active NPI

Block Island Health Services, Inc.

  • Clinic/Center
  • Block Island, RI
National Provider Identifier
1073544664
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
ACF01524 Issued in RI
Legal business name
BLOCK ISLAND HEALTH SERVICES, INC.
Practice address
6 Payne Road
Block Island, RI 02807-0919
Phone
(401) 466-2125
Fax
(401) 466-5476
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. James M Stover
Title
Executive Director
Phone
(401) 466-2125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ACF01524 RI Primary

Addresses

Primary practice location

6 Payne Road
Block Island, RI 02807-0919

Mailing address

P.O. Box 919
6 Payne Road
Block Island, RI 02807-0919
Phone (401) 466-2125

Other names 1

  • Block Island Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050728001008 RI Part B Supplier - Clinic/Group Practice 3173551421 Receives reassigned benefits from 4 practitioners
Practice locations: Block Island, RI
O20220805000632 RI Part A Provider - Rural Health Clinic 3173551421 Practice locations: Block Island, RI

Rural health clinic certification: CCN 413803

Legal name
BLOCK ISLAND HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 31, 2023
Last certification
Mar 17, 2026
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 10, 1984 in RI
Enrollment address
6 Payne Rd
Block Island, RI 02807-7761

National Provider Directory

National Provider Directory
Tax ID family
Block Island Health Servics3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Laura a Parsons Individual OtherVice Chair Jun 1, 2021
Nancy Ruddle Individual Other Jun 1, 2021
Alison T Warfel Individual Corporate OfficerCoo Jul 1, 2020
Operational/Managerial ControlCoo Jul 1, 2020
Susan Stover Individual OtherChair Jun 1, 2021
Thomas K Warcup Individual Corporate OfficerCeo May 1, 2020
Corporate DirectorMedical Director May 1, 2020
Pamela Austen Individual Other Jun 1, 2022
Robin Vila Individual Other Jun 1, 2021
Brian R Ott Individual Other Jun 1, 2021
Michael Brownstein Individual Other Jun 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073544664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 919",
            "address_2": "6 PAYNE ROAD",
            "city": "BLOCK ISLAND",
            "state": "RI",
            "postal_code": "028070919",
            "telephone_number": "401-466-2125",
            "fax_number": "401-466-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PAYNE ROAD",
            "city": "BLOCK ISLAND",
            "state": "RI",
            "postal_code": "028070919",
            "telephone_number": "401-466-2125",
            "fax_number": "401-466-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOCK ISLAND HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOVER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "401-466-2125",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "RI",
            "license": "ACF01524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Block Island Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Block Island, RI

Sources for this page

Verify at the official NPI Registry.