The Tavares Pediatric Center Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

RI 642 Issued in RI

Legal business name

THE TAVARES PEDIATRIC CENTER INC

Practice address

101 Plain St
Providence, RI 02903-4824

Phone

(401) 272-7127

Fax

(401) 272-4752

NPI assigned

Jul 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Eugene F Tavares, LICENSED

Title

Administrator

Phone

(401) 272-7127

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1366442899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034824",
            "telephone_number": "401-272-7127",
            "fax_number": "401-272-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034824",
            "telephone_number": "401-272-7127",
            "fax_number": "401-272-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TAVARES PEDIATRIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-27",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "TAVARES",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-272-7127",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICENSED"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "RI 642",
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "RI",
            "license": "RI 642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41G085",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Rhode Island Coalition for the Homeless, Inc.
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• The Wellness Center Ri, LLC
• Ronald W Thebarge, PHD
• Nerlandes P Themistocle
• Theodore C. Palumbo, MD, Inc.

• All providers in Providence, RI
• Intellectual Disabilities Intermediate Care Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.