Aquene Holistic Chiropractic Center, Inc

Organization Active NPI Chiropractor · Middletown, RI

NPI 1073710596 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1073710596
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
DCP00403 (RI)
Legal business name
AQUENE HOLISTIC CHIROPRACTIC CENTER, INC
Practice address
333 Valley Rd
Middletown, RI 02842-7230
Phone
(401) 845-9283
NPI assigned
Jun 28, 2007
Organization subpart
No

Authorized official

Name
Dr. Kristine Dawn Thomas, D.O.
Title
Chiropractor
Phone
(401) 845-9283

Practitioners 3

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

National Provider Directory

Locations

333 Valley Rd
Middletown, RI 02842
Phone (401) 338-5174

2077 W Shore Rd
Warwick, RI 02889
Phone (401) 338-5174

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X DCP00403 RI Yes

Addresses

Primary practice location

333 Valley Rd
Middletown, RI 02842-7230

Mailing address

333 Valley Rd
Middletown, RI 02842-7230
Phone (401) 845-9283

Other identifiers

IdentifierTypeStateIssuer
9714511MedicaidMA
CP 00408096OtherRIBC BLUE CHIP
0000023204-001OtherRIBCBS

Other names

  • Aqidneck Island Wellness Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073710596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028427230",
            "telephone_number": "401-845-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028427230",
            "telephone_number": "401-845-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUENE HOLISTIC CHIROPRACTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "401-845-9283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "DCP00403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9714511",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BLUE CHIP",
            "identifier": "CP 00408096",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0000023204-001",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aqidneck Island Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, RI

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Sources for this page

Verify at the official NPI Registry.