Individual provider Active NPI

Tabitha Ann Imondi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln, RI
National Provider Identifier
1205350980
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN01646 Issued in RI
Practice address
1525 Old Louisquisset Pike Ste 203
Lincoln, RI 02865-4503
Phone
(774) 291-0617
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN01646 RI Primary

Addresses

Primary practice location

1525 Old Louisquisset Pike Ste 203
Lincoln, RI 02865-4503

Mailing address

19 Jeffrey Dr
North Scituate, RI 02857-2939
Phone (401) 829-6788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN01646RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Psychiatry LLC Psychiatric/Mental Health Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1205350980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 JEFFREY DR",
            "city": "NORTH SCITUATE",
            "state": "RI",
            "postal_code": "028572939",
            "telephone_number": "401-829-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 OLD LOUISQUISSET PIKE STE 203",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654503",
            "telephone_number": "774-291-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMONDI",
        "first_name": "TABITHA",
        "middle_name": "ANN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN01646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.