Individual provider Active NPI

Jennifer Rachael Fallon, FNP-BC

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1184435810
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN04393 Issued in RI
Practice address
44 W River St
Providence, RI 02904-2609
Phone
(401) 274-4800
Fax
(401) 454-4800
NPI assigned
Jan 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN04393 RI Primary

Addresses

Primary practice location

44 W River St
Providence, RI 02904-2609

Mailing address

PO Box 202230
Dallas, TX 75320-2230
Phone (401) 274-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250221001031 RI Practitioner - Nurse Practitioner 1759801608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates IncGroup PAC ID 6103886528, 14 clinicians
University Gastroenterology, LLCGroup PAC ID 3678762804, 99 clinicians

Practice addresses (Care Compare)

44 W River St
Providence, RI 02904-2609
Phone (401) 274-4800

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • 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
University Gastroenterology, LLC CurrentSince Aug 1, 2025 Accepting new patients
Gastroenterology Associates Inc CurrentSince Feb 1, 2025 Accepting new patients

Locations

44 W River St
Fl 2
Providence, RI 02904

33 Staniford St
Providence, RI 02905
Phone (401) 274-1810

44 W River St
Providence, RI 02904
Phone 4012744800201

44 W River St
Ste 2
Providence, RI 02904

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBICBD

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 5

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": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1184435810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753202230",
            "telephone_number": "401-274-4800",
            "fax_number": "401-454-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 W RIVER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042609",
            "telephone_number": "401-274-4800",
            "fax_number": "401-454-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "JENNIFER",
        "middle_name": "RACHAEL",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN04393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.