Jennifer Grant Budacki, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO00939 Issued in RI

Practice address

1272 W Main Rd
Middletown, RI 02842-6405

Phone

(401) 847-2290

Fax

(401) 849-8446

NPI assigned

Apr 5, 2012

Last updated

Dec 16, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Aquidneck Pediatrics LLC

  • Pediatrics Physician
  • Middletown, RI
  • NPI 1245681626
  NPD
• Pediatric Associates of Fall River, Inc

  • Pediatrics Physician
  • Fall River, MA
  • NPI 1619930146
  NPD (past)
• Southcoast Hospitals Group, Inc

  dba Charlton Memorial Hospital

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1306871223
  NPD (past)

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1073879870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 LANGHORNE NEWTOWN RD",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 W MAIN RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028426405",
            "telephone_number": "401-847-2290",
            "fax_number": "401-849-8446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Langhorne Newtown Rd",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190471201",
            "country_code": "US",
            "telephone_number": "215-710-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUDACKI",
        "first_name": "JENNIFER",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS017608",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "DO00939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Britto
• Tara Elizabeth Bronson, MSN, FNP-C
• April Bell Brosnan, FNP-C
• Ashlin Paige Brown, PA-C
• Joshua Charles Brown, M.D.
• Ross Michael Budacki, M.D
• Tal Buntinx, MD
• Erin Beth Burdick, RN
• Andrea M Burdon, APRN-CNP
• Billie Burke, PA-C

• Pediatrics Physician in Middletown, RI
• Providers in Middletown, RI by specialty
• Pediatrics Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.