Individual provider Active NPI

Kenisha Latoya Starks, FNP-BC

  • Nurse Practitioner
  • Fall River, MA
National Provider Identifier
1336885722
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN04337 Issued in RI
Practice address
1030 President Ave Ste 1001
Fall River, MA 02720-5928
Phone
(508) 973-9650
NPI assigned
May 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN04337 RI Primary

Addresses

Primary practice location

1030 President Ave Ste 1001
Fall River, MA 02720-5928

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 273-0641

Other practice location 1

100 Dudley St Fl 3
Providence, RI 02905-3233
Phone (401) 453-7953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220711000331 MA Practitioner - Nurse Practitioner 6608256425 Reassigns benefits to 1 organization
I20250408002172 RI Practitioner - Nurse Practitioner 6608256425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN04337RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Affinity Physicians LLC. Current Accepting new patients
Affinity Physicians LLC CurrentSince Jun 1, 2025 Accepting new patients
Women & Infants Hospital of Rhode Island Past Accepting new patients

Locations

387 Quarry St
Ste 100
Fall River, MA 02723
Phone (508) 679-8111

1030 President Ave
Ste 1001
Fall River, MA 02720
Phone (508) 973-9650

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

100 Dudley St
Fl 3
Providence, RI 02905

100 Dudley St
Fl 3-3
Providence, RI 02905
Phone (401) 453-3795

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 5

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

Hospital & facility affiliations 4

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": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1336885722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 PRESIDENT AVE STE 1001",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205928",
            "telephone_number": "508-973-9650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Dudley St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053233",
            "country_code": "US",
            "telephone_number": "401-453-7953",
            "fax_number": "401-453-7790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARKS",
        "first_name": "KENISHA",
        "middle_name": "LATOYA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-09",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN04337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.