Individual provider Active NPI

Rita Nenonen, MD

  • Pediatrics Physician
  • Providence, RI
National Provider Identifier
1215047618
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD05716 Issued in RI
Practice address
593 Eddy St
Claverick 2
Providence, RI 02903-4923
Phone
(401) 854-2504
Fax
(401) 854-2519
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X MD05716 RI
Pediatrics Physician 208000000X MD05716 RI Primary

Addresses

Primary practice location

593 Eddy St
Claverick 2
Providence, RI 02903-4923

Mailing address

PO Box 9484
Providence, RI 02940-9484
Phone (401) 854-2500

Other identifiers 9

IdentifierTypeStateIssuer
12/29/2008OtherMATUFTS HEALTH PLAN
11/12/2009OtherRINHPRI
007008106OtherRIMEDICARE - TYPE UNSPECIFI
10/01/2008OtherRIBCBS
1215047618OtherRINPI
04/15/2009OtherRIUNITED HEALTH CARE
7002203MedicaidRI
939025129OtherRIRI MEDICARE GROUP NUMBER
3206211MedicaidMA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1215047618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9484",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029409484",
            "telephone_number": "401-854-2500",
            "fax_number": "401-854-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "CLAVERICK 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-854-2504",
            "fax_number": "401-854-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NENONEN",
        "first_name": "RITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "RI",
            "license": "MD05716",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD05716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "12/29/2008",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHPRI",
            "identifier": "11/12/2009",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - TYPE UNSPECIFI",
            "identifier": "007008106",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10/01/2008",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215047618",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "04/15/2009",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002203",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE GROUP NUMBER",
            "identifier": "939025129",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3206211",
            "state": "MA"
        }
    ],
    "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 Sep 18, 2013; 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.