NPIMap

Individual provider Active NPI

Constance Marie Ducharme, NP

  • Primary Care Nurse Practitioner
  • North Providence, RI
National Provider Identifier
1114558244
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN02253 Issued in RI
Practice address
966 Mineral Spring Ave
North Providence, RI 02904-4933
Phone
(401) 475-3063
Fax
(401) 475-0593
NPI assigned
Jan 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN02253 RI Primary

Addresses

Primary practice location

966 Mineral Spring Ave
North Providence, RI 02904-4933

Mailing address

966 Mineral Spring Ave
North Providence, RI 02904-4933
Phone (401) 475-3063

Other practice location 1

300 Richmond St
Providence, RI 02903-4222
Phone (401) 430-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200402003429 RI Practitioner - Nurse Practitioner 6901235530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Fairlawn Primary Care IncGroup PAC ID 0941289375, 2 clinicians

Practice addresses (Care Compare)

966 Mineral Spring Ave
North Providence, RI 02904-4933
Phone (401) 475-3063

Hospital & facility affiliations

  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baxter Palliative Consulting LLC CurrentSince May 2, 2022 Accepting new patients
Fairlawn Primary Care, Inc CurrentSince Apr 8, 2020 Accepting new patients

Locations

966 Mineral Spring Ave
North Providence, RI 02904
Phone (401) 475-3063

55 Cherry Ln
Wakefield, RI 02879
Phone (401) 789-1367

Interoperability endpoints

  • Direct secure messaging: cducharme@direct.carene.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1114558244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 MINERAL SPRING AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044933",
            "telephone_number": "401-475-3063",
            "fax_number": "401-475-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 MINERAL SPRING AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044933",
            "telephone_number": "401-475-3063",
            "fax_number": "401-475-0593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Richmond St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034222",
            "country_code": "US",
            "telephone_number": "401-430-2000",
            "fax_number": "401-453-7597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUCHARME",
        "first_name": "CONSTANCE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "RI",
            "license": "APRN02253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Providence, RI

Sources for this page

Verify at the official NPI Registry.