Organization Active NPI

Thundermist Health Center

  • Federally Qualified Health Center (FQHC)
  • Woonsocket, RI
National Provider Identifier
1366056830
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THUNDERMIST HEALTH CENTER
Practice address
450 Clinton St
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
NPI assigned
Sep 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Ckarla Agudelo
Title
Director of Credentialing
Phone
(401) 767-4100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Community/Behavioral Health Agency 251S00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

450 Clinton St
Woonsocket, RI 02895-3207

Mailing address

25 John a Cummings Way Ste 203
Woonsocket, RI 02895-3244
Phone (401) 767-4100

Other practice location 1

1 River St
Wakefield, RI 02879-3214
Phone (401) 767-4100

Other practice location 2

186 Providence St
West Warwick, RI 02893-2508
Phone (401) 615-2800

Other practice location 3

360 Kingstown Rd Unit 101
Narragansett, RI 02882-3258
Phone (401) 789-6492

Other identifiers 1

IdentifierTypeStateIssuer
4101805MedicaidRI

National Provider Directory

National Provider Directory
Tax ID family
Thundermist Health Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1366056830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 JOHN A CUMMINGS WAY STE 203",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953244",
            "telephone_number": "401-767-4100"
        },
        {
            "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": "401-767-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 River St",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028793214",
            "country_code": "US",
            "telephone_number": "401-767-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "186 Providence St",
            "address_purpose": "LOCATION",
            "city": "West Warwick",
            "state": "RI",
            "postal_code": "028932508",
            "country_code": "US",
            "telephone_number": "401-615-2800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Kingstown Rd Unit 101",
            "address_purpose": "LOCATION",
            "city": "Narragansett",
            "state": "RI",
            "postal_code": "028823258",
            "country_code": "US",
            "telephone_number": "401-789-6492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THUNDERMIST HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "AGUDELO",
        "authorized_official_first_name": "CKARLA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "401-767-4100"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4101805",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.