Organization Active NPI

Genesis Elder Care Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Warwick, RI
National Provider Identifier
1194774943
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
GENESIS ELDER CARE PHYSICIAN SERVICES LLC
Practice address
660 Commonwealth Avenue
Warwick, RI 02886-2707
Phone
(401) 739-4241
Fax
(401) 732-3358
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Authorized official

Name
Margaret Jean Baker
Title
Dir of Bus Ops
Phone
(410) 494-7607

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X NPP37084 RI

Addresses

Primary practice location

660 Commonwealth Avenue
Warwick, RI 02886-2707

Mailing address

PO Box 42738
Towson, MD 21284-2738
Phone (860) 687-3629

Other identifiers 1

IdentifierTypeStateIssuer
9004790MedicaidRI

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 29)

20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734

1253 Hartford Tpke
Vernon Rockville, CT 06066
Phone (860) 375-7315

545 Palisado Ave
Windsor, CT 06095
Phone (203) 820-6093

1150 Varnum St NE
Ste 312
Washington, DC 20017

1080 Silver Lake Blvd
Dover, DE 19904
Phone (302) 734-5990

118 Enterprise Ct
Columbus, GA 31904

2365 Nashville Rd
Bowling Green, KY 42101
Phone (270) 782-9961

462 Main St
Ste 214
Agawam, MA 01001

462 Main St
Agawam, MA 01001
Phone (413) 786-9704

200 Brickstone Sq
Ste 301
Andover, MA 01810
Phone (978) 474-7500

455 Brayton Ave
Somerset, MA 02726
Phone (508) 649-2240

3 Park Dr
Westford, MA 01886
Phone (978) 392-1144

3400 Erdman Ave
Baltimore, MD 21213
Phone (410) 485-3567

2850 North Ridge Rd
Ste 203
Ellicott City, MD 21043
Phone (410) 480-2803

65 Thomas Johnson Dr
Ste C
Frederick, MD 21702
Phone (301) 663-3836

347 Ballenger Center Dr
Frederick, MD 21703
Phone (301) 633-5181

1346 S Division St
Ste 103
Salisbury, MD 21804
Phone (410) 749-2599

6508 Deer Pointe Dr
Salisbury, MD 21804
Phone (410) 742-6016

515 Fairmount Ave
Fl 9
Towson, MD 21286
Phone (410) 494-7671

515 Fairmount Ave
#9
Towson, MD 21286

100F Walkers Village Way
Walkersville, MD 21793

175 Blueberry Ln
Laconia, NH 03246
Phone (603) 524-3340

30 Canton St
Ste 13
Manchester, NH 03103
Phone (603) 625-1670

5123 Juan Tabo Blvd NE
Ste 1
Albuquerque, NM 87111

1831 Camino del Llano
Belen, NM 87002
Phone (505) 864-1600

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1194774943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42738",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212842738",
            "telephone_number": "860-687-3629",
            "fax_number": "860-687-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 COMMONWEALTH AVENUE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862707",
            "telephone_number": "401-739-4241",
            "fax_number": "401-732-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS ELDER CARE PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DIR OF BUS OPS",
        "authorized_official_telephone_number": "410-494-7607"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "NPP37084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9004790",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.