Individual provider Active NPI

Jillian Patricia Clifford, APRN

  • Nurse Practitioner
  • Cranston, RI
National Provider Identifier
1366937849
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN01878 Issued in RI
Practice address
1150 Reservoir Ave Ste 300
Cranston, RI 02920-6032
Phone
(401) 223-2828
Fax
(401) 223-2825
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN01878 RI
Nurse Practitioner 363L00000X APRN01878 RI Primary

Addresses

Primary practice location

1150 Reservoir Ave Ste 300
Cranston, RI 02920-6032

Mailing address

1150 Reservoir Ave Ste 300
Cranston, RI 02920-6032
Phone (401) 223-2828

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181220001472 RI Practitioner - Nurse Practitioner 9436494382 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venus OB-GYN IncGroup PAC ID 5092075226, 6 clinicians

Practice addresses (Care Compare)

1150 Reservoir Ave
Suite 300
Cranston, RI 02920-6043
Phone (401) 223-2828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN01878RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Current Accepting new patients
Ocean State Primary Care LLC CurrentSince Nov 18, 2018 Accepting new patients
Amir Alizadeh, MD, Inc CurrentSince Mar 1, 2020 Accepting new patients
Venus OB-GYN Inc CurrentSince Apr 29, 2024 Accepting new patients

Locations

1150 Reservoir Ave
Ste 300
Cranston, RI 02920
Phone (401) 223-2828

725 Reservoir Ave
Ste 306
Cranston, RI 02910
Phone (401) 780-5557

1637 Mineral Spring Ave
Ste 107
North Providence, RI 02904
Phone (401) 354-4100

1637 Mineral Spring Ave
#10
North Providence, RI 02904
Phone (401) 354-4400

176 Toll Gate Rd
Ste 203
Warwick, RI 02886
Phone (401) 739-4350

Interoperability endpoints

  • Direct secure messaging: jclifford@direct.carene.org

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 and National Provider Directory roles.

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1366937849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 300",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206032",
            "telephone_number": "401-223-2828",
            "fax_number": "401-223-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 300",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206032",
            "telephone_number": "401-223-2828",
            "fax_number": "401-223-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "JILLIAN",
        "middle_name": "PATRICIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN01878",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN01878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.