Active NPI
Lynn H Sommerville MD PHD
- Internal Medicine Physician
- Providence, RI
National Provider Identifier
1194877704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD06858
- Legal business name
- LYNN H SOMMERVILLE MD PHD
- Practice address
- 100 Highland Ave
#302
Providence, RI 02906 - Phone
- (401) 331-8338
- Fax
- (401) 331-0573
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Lynn Holley Sommerville, MD
- Title
- Physician Owner
- Phone
- (401) 331-8338
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD06858 | RI | Primary |
Addresses
Primary practice location
100 Highland Ave
#302
Providence, RI 02906
Mailing address
100 Highland Ave
#302
Providence, RI 02906
Phone (401) 331-8338
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204125 | Other | RI | BLUE CROSS BLUE SHIELD RI |
| 0400917 | Other | RI | UNITED HEALTH CARE |
| 9020412 | Medicaid | RI |
National Provider Directory
National Provider DirectoryLocations
100 Highland Ave
Ste 302
Providence, RI 02906
Phone (401) 331-8338
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Providence, RI
- NPI 1063586295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1194877704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HIGHLAND AVE",
"address_2": "#302",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02906",
"telephone_number": "401-331-8338",
"fax_number": "401-331-0573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HIGHLAND AVE",
"address_2": "#302",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02906",
"telephone_number": "401-331-8338",
"fax_number": "401-331-0573"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LYNN H SOMMERVILLE MD PHD",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-17",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SOMMERVILLE",
"authorized_official_first_name": "LYNN",
"authorized_official_middle_name": "HOLLEY",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "401-331-8338",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "RI",
"license": "MD06858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD RI",
"identifier": "204125",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "0400917",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9020412",
"state": "RI"
}
],
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.