NPIMap

Organization Active NPI

Pai Participant 5 PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Coventry, RI
National Provider Identifier
1194381947
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PAI PARTICIPANT 5 PC
Practice address
10 Woodland Dr
Coventry, RI 02816-6716
Phone
(859) 291-4800
Fax
(833) 694-1507
NPI assigned
May 17, 2019
Last updated
Aug 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Brittain Brantley
Title
Acting President
Phone
(302) 300-5138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

10 Woodland Dr
Coventry, RI 02816-6716

Mailing address

PO Box 639676
Cincinnati, OH 45263-9676
Phone (859) 291-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC, RI, WV, IA5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20190703000887 PA Part B Supplier - Clinic/Group Practice 8325372881 Receives reassigned benefits from 5 practitioners
O20210405001329 SC Part B Supplier - Clinic/Group Practice 8325372881 Receives reassigned benefits from 4 practitioners
Practice locations: Clinton, SC; Newberry, SC
O20220615000638 RI Part B Supplier - Clinic/Group Practice 8325372881 Receives reassigned benefits from 9 practitioners
Practice locations: Cumberland, RI; Woonsocket, RI; Wakefield, RI; Tiverton, RI; Smithfield, RI; Providence, RI; North Providence, RI; North Kingstown, RI…
O20220726001128 WV Part B Supplier - Clinic/Group Practice 8325372881 Receives reassigned benefits from 16 practitioners
Practice locations: Beckley, WV; White Sulphur Springs, WV; Wayne, WV; Spencer, WV; South Charleston, WV; Sistersville, WV; Sissonville, WV; Shepherdstown, WV…
O20260604001717 IA Part B Supplier - Clinic/Group Practice 8325372881 Receives reassigned benefits from 1 practitioner
Practice locations: Muscatine, IA

National Provider Directory

National Provider Directory

Locations

550 Glenwood Dr
Mooresville, NC 28115
Phone (704) 644-4797

740 Oak Hill Rd
North Kingstown, RI 02852
Phone (401) 294-4545

2044 Pageland Hwy
Lancaster, SC 29720
Phone (252) 210-9015

1821 Grove St
Marysville, WA 98270
Phone (360) 659-3926

800 N Medcalf Ln
Montesano, WA 98563
Phone (360) 249-2273

17 E 8th Ave
Spokane, WA 99202
Phone (509) 474-5678

9287 N Nevada St
Spokane, WA 99218
Phone (509) 468-7000

200 Monday Dr
Hamlin, WV 25523
Phone (304) 586-0771

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1194381947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639676",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639676",
            "telephone_number": "859-291-4800",
            "fax_number": "859-655-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND DR",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166716",
            "telephone_number": "859-291-4800",
            "fax_number": "833-694-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAI PARTICIPANT 5 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-17",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "BRITTAIN",
        "authorized_official_title_or_position": "ACTING PRESIDENT",
        "authorized_official_telephone_number": "302-300-5138"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coventry, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.