NPIMap

Organization Active NPI

St Joseph Health Services of Rhode Island

  • Family Medicine Physician
  • Providence, RI
National Provider Identifier
1114186715
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
HOS00110 Issued in RI
Legal business name
ST JOSEPH HEALTH SERVICES OF RHODE ISLAND
Practice address
21 Peace St
Providence, RI 02907-1510
Phone
(401) 456-3309
Fax
(401) 456-3762
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Mr. John Fogerty
Title
President - Ceo
Phone
(401) 456-3309

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133N00000X HOS00110 RI
InterpreterGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171R00000X HOS00110 RI
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X HOS00110 RI Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RE0101X HOS001100 RI
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X HOS00110 RI

Addresses

Primary practice location

21 Peace St
Providence, RI 02907-1510

Mailing address

200 High Service Ave
4TH FL Marion Hall
North Providence, RI 02904-5113
Phone (401) 456-3309

Other identifiers 1

IdentifierTypeStateIssuer
2127OtherRIPROGROUP (NHP)

National Provider Directory

National Provider Directory
Tax ID family
Psychiatric Health Serv5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1114186715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH SERVICE AVE",
            "address_2": "4TH FL MARION HALL",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045113",
            "telephone_number": "401-456-3309",
            "fax_number": "401-456-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PEACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071510",
            "telephone_number": "401-456-3309",
            "fax_number": "401-456-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH HEALTH SERVICES OF RHODE ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "FOGERTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT - CEO",
        "authorized_official_telephone_number": "401-456-3309",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "171R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Interpreter",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "HOS00110",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "RI",
            "license": "HOS001100",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROGROUP (NHP)",
            "identifier": "2127",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.