Active NPI
Marklyn Perry Champagne, MSW
- Clinical Social Worker
- East Greenwich, RI
National Provider Identifier
1235235250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW00060
- Practice address
- 126 Peirce St
East Greenwich, RI 02818-3833 - Phone
- (401) 886-0821
- Fax
- (401) 886-0693
- NPI assigned
- Sep 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW00060 | RI | Primary |
Addresses
Primary practice location
126 Peirce St
East Greenwich, RI 02818-3833
Mailing address
126 Peirce St
East Greenwich, RI 02818-3833
Phone (401) 886-0821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2017 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW00060 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235235250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 PEIRCE ST",
"city": "EAST GREENWICH",
"state": "RI",
"postal_code": "028183833",
"telephone_number": "401-886-0821",
"fax_number": "401-886-0693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 PEIRCE ST",
"city": "EAST GREENWICH",
"state": "RI",
"postal_code": "028183833",
"telephone_number": "401-886-0821",
"fax_number": "401-886-0693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPAGNE",
"first_name": "MARKLYN",
"middle_name": "PERRY",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW00060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Greenwich, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.