NPIMap

Organization Active NPI

Blackstone Valley Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Pawtucket, RI
National Provider Identifier
1104046226
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
ACG01536 Issued in RI
Legal business name
BLACKSTONE VALLEY COMMUNITY HEALTH CARE
Practice address
210 Main St
Pawtucket, RI 02860-4008
Phone
(401) 312-9892
Fax
(401) 312-0139
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Authorized official

Name
Cristina Pacheco, MD
Title
Ceo
Phone
(401) 722-0081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X ACG01536 RI Primary

Addresses

Primary practice location

210 Main St
Pawtucket, RI 02860-4008

Mailing address

39 East Ave
Pawtucket, RI 02860-4003
Phone (401) 312-9892

Other identifiers 1

IdentifierTypeStateIssuer
BVCHC09336MedicaidRI

National Provider Directory

National Provider Directory
Tax ID family
Blackstone Valley Community Health Care Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

210 Main St
Pawtucket, RI 02860
Phone (401) 312-9892

Practitioners & affiliated clinicians

Practitioners 4

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": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1104046226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604003",
            "telephone_number": "401-312-9892",
            "fax_number": "401-312-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MAIN ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604008",
            "telephone_number": "401-312-9892",
            "fax_number": "401-312-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE VALLEY COMMUNITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "401-722-0081",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "RI",
            "license": "ACG01536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BVCHC09336",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.