Wickford Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

08781 Issued in RI

Legal business name

WICKFORD FAMILY MEDICINE LLC

Practice address

320 Phillips St
Suite 204
North Kingstown, RI 02852-5149

Phone

(401) 450-2111

NPI assigned

Mar 7, 2011

Organization subpart

No

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

Authorized official

Name

John Machata, M.D.

Title

Medical Director

Phone

(401) 450-2111

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1104124734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 118",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028520118",
            "telephone_number": "401-450-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PHILLIPS ST",
            "address_2": "SUITE 204",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028525149",
            "telephone_number": "401-450-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKFORD FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "MACHATA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "401-450-2111",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "08781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Lynne Welitoff, MSW,LICSW
• Elizabeth Welshman, LICSW
• Lisa Weyandt, PH.D.
• Bryana FC White, MA PYSCH
• Gerald J White
• Wickford Family Practice LLC
• Wickford Internists, Inc.
• Wickford Optical, LLC
• Wickford Orthodontics
• Wickford Orthodontics, LLC

• Family Medicine Physician in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Family Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.