NPIMap

Organization Active NPI

Family Doctors of East Providence, Inc.

  • Legal Medicine
  • Riverside, RI
National Provider Identifier
1245267509
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
RI9206 Issued in RI
Legal business name
FAMILY DOCTORS OF EAST PROVIDENCE, INC.
Practice address
1445 Wampanoag TRL
Unit 205
Riverside, RI 02915-1000
Phone
(401) 434-0770
Fax
(401) 633-6094
NPI assigned
Jun 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James M. Schwartz, M.D.
Title
President
Phone
(401) 434-0770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X RI9206 RI Primary

Addresses

Primary practice location

1445 Wampanoag TRL
Unit 205
Riverside, RI 02915-1000

Mailing address

1445 Wampanoag TRL
Unit 205
Riverside, RI 02915-1000
Phone (401) 434-0770

Other identifiers 3

IdentifierTypeStateIssuer
7004039MedicaidRI
7005523MedicaidRI
JA24654MedicaidRI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245267509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 WAMPANOAG TRL",
            "address_2": "UNIT 205",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151000",
            "telephone_number": "401-434-0770",
            "fax_number": "401-633-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 WAMPANOAG TRL",
            "address_2": "UNIT 205",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151000",
            "telephone_number": "401-434-0770",
            "fax_number": "401-633-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DOCTORS OF EAST PROVIDENCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-434-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "RI",
            "license": "RI9206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004039",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005523",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JA24654",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, 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.

Verify at the official NPI Registry.