Active NPI
Byron T Alex
- Pediatrics Physician
- Providence, RI
National Provider Identifier
1114212404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD15915
- Practice address
- 355 Prairie Ave
Providence, RI 02905-1928 - Phone
- (401) 444-0570
- Fax
- (401) 444-0427
- NPI assigned
- Jun 14, 2011
- Last updated
- Dec 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD15915 | RI | Primary |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 15915 | RI |
Addresses
Primary practice location
355 Prairie Ave
Providence, RI 02905-1928
Mailing address
375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15915 | RI | MD | Pediatrics Physician |
| 15915 | RI | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513123200000",
"number": "1114212404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 ALLENS AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029055010",
"telephone_number": "401-444-0400",
"fax_number": "401-444-0468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 PRAIRIE AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029051928",
"telephone_number": "401-444-0570",
"fax_number": "401-444-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEX",
"first_name": "BYRON",
"middle_name": "T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-14",
"last_updated": "2017-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "RI",
"license": "MD15915",
"primary": true
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "RI",
"license": "15915",
"primary": false
}
],
"identifiers": [],
"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 Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.