NPIMap

Organization Active NPI

Rhode Island Integrated Medicine

  • Occupational Health Chiropractor
  • Cranston, RI
National Provider Identifier
1104848670
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
OT0018 Issued in RI
Legal business name
RHODE ISLAND INTEGRATED MEDICINE
Practice address
521 Park Ave
Cranston, RI 02910-2346
Phone
(401) 781-3374
Fax
(401) 781-3376
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Dr. Victor M Pedro, DC
Title
Director
Phone
(401) 781-3374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0100X OT0018 RI Primary

Addresses

Primary practice location

521 Park Ave
Cranston, RI 02910-2346

Mailing address

521 Park Ave
Cranston, RI 02910
Phone (401) 781-3374

Other identifiers 3

IdentifierTypeStateIssuer
OT00018OtherRIRI STATE LICENCE
413445OtherRIBLUE CHIP PROV NUMBER
31492OtherRIBLUE CROSS PROV NUMBER

Other names 1

  • RI Integrated Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rhode Island Integrated Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1104848670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 PARK AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "02910",
            "telephone_number": "401-781-3374",
            "fax_number": "401-781-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 PARK AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102346",
            "telephone_number": "401-781-3374",
            "fax_number": "401-781-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHODE ISLAND INTEGRATED MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "PEDRO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "401-781-3374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": "RI",
            "license": "OT0018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI STATE LICENCE",
            "identifier": "OT00018",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP PROV NUMBER",
            "identifier": "413445",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROV NUMBER",
            "identifier": "31492",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RI Integrated Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.