Individual provider Active NPI

Stephen S Falkenberry, MD

  • Family Medicine Physician
  • Woonsocket, RI
National Provider Identifier
1346312717
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD08002 Issued in RI
Practice address
450 Clinton St
Woonsocket, RI 02895-3207
Phone
(017) 674-1004
NPI assigned
Nov 14, 2006
Last updated
Dec 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X MD08802 RI
Surgical Oncology Physician 2086X0206X MD08802 RI
Family Medicine Physician 207Q00000X MD08002 RI Primary

Addresses

Primary practice location

450 Clinton St
Woonsocket, RI 02895-3207

Mailing address

235 Plain Street
Suite 204
Providence, RI 02905
Phone (401) 453-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110215000379 RI Practitioner - Family PracticePractitioner - Gynecological OncologyPractitioner - Other (Physician) 2163602764 Reassigns benefits to 1 organization
I20181228000387 TX Practitioner - Family Practice 2163602764 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD08002RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Jan 13, 2020 Accepting new patients
DHHS IHS Phoenix Area Family Medicine CurrentSince Oct 29, 2018 Accepting new patients
Thundermist Health Center CurrentSince Jan 13, 2020 Accepting new patients
Thundermist Health Center Current Accepting new patients
Women & Infants Hospital of Rhode Island Past Accepting new patients

Locations

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1346312717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PLAIN STREET",
            "address_2": "SUITE 204",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02905",
            "telephone_number": "401-453-4242",
            "fax_number": "401-453-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "017-674-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALKENBERRY",
        "first_name": "STEPHEN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "RI",
            "license": "MD08802",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "RI",
            "license": "MD08802",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD08002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.