Individual provider Active NPI

Jenny R David, DO

  • Obstetrics & Gynecology Physician
  • Providence, RI
National Provider Identifier
1275916702
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DO00990 Issued in RI
Practice address
40 Candace St
Providence, RI 02908
Phone
(401) 444-0550
Fax
(401) 444-0425
NPI assigned
Jul 1, 2015
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DO00990 RI Primary

Addresses

Primary practice location

40 Candace St
Providence, RI 02908

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdavid59133@HCNetwork.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191018000339 RI Practitioner - Obstetrics/Gynecology 3971809724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of New England, College of Osteo Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

40 Candace St
Providence, RI 02908-3747
Phone (401) 444-0550

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO00990RIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Community Health Centers, Inc CurrentSince Sep 23, 2019 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Jan 1, 2025 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Jan 1, 2025 Accepting new patients
The Providence Community Health Centers Inc. Past Accepting new patients

Locations

375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400

40 Candace St
Providence, RI 02908
Phone (401) 444-0550

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

Interoperability endpoints

  • Direct secure messaging: jdavid59133@hcnetwork.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1275916702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CANDACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02908",
            "telephone_number": "401-444-0550",
            "fax_number": "401-444-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "JENNY",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "DO00990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdavid59133@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "40 Candace St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "02908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.