NPIMap

Organization Active NPI

Petitpas Psychiatric Services, LLC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Cranston, RI
National Provider Identifier
1245695964
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
PCNS00064 Issued in RI
Legal business name
PETITPAS PSYCHIATRIC SERVICES, LLC
Practice address
900 Reservoir Ave
Ste.2
Cranston, RI 02910-4453
Phone
(401) 944-0194
Fax
(401) 944-0196
NPI assigned
Dec 22, 2015
Last updated
Dec 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Authorized official

Name
Mrs. Patricia A Petitpas, APRN/PCNSNPI 1457446593
Title
Owner
Phone
(401) 944-0194

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0809X PCNS00064 RI Primary

Addresses

Primary practice location

900 Reservoir Ave
Ste.2
Cranston, RI 02910-4453

Mailing address

900 Reservoir Ave
Ste.2
Cranston, RI 02910-4453
Phone (401) 944-0194

Other identifiers 3

IdentifierTypeStateIssuer
413965OtherRIRI BLUE CHIP PROVIDER #
0000032309OtherRIRI BLUE CROSS PROVIDER #
6228710OtherRIUNITED HEALTH PROVIDER #

National Provider Directory

National Provider Directory

Locations

900 Reservoir Ave
Ste 2
Cranston, RI 02910
Phone (401) 497-7404

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": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1245695964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RESERVOIR AVE",
            "address_2": "STE.2",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104453",
            "telephone_number": "401-944-0194",
            "fax_number": "401-944-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 RESERVOIR AVE",
            "address_2": "STE.2",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104453",
            "telephone_number": "401-944-0194",
            "fax_number": "401-944-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETITPAS PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "PETITPAS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-944-0194",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN/PCNS"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "RI",
            "license": "PCNS00064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP PROVIDER #",
            "identifier": "413965",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS PROVIDER #",
            "identifier": "0000032309",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PROVIDER #",
            "identifier": "6228710",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.