Organization Active NPI

Unique Diversity Innovation LLC

  • Community Health Clinic/Center
  • Providence, RI
National Provider Identifier
1376430470
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
UNIQUE DIVERSITY INNOVATION LLC
Practice address
715 Branch Ave
Providence, RI 02904-2248
Phone
(508) 345-4151
NPI assigned
Jun 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Shanee S Vega, LPIM
Title
Ceo
Phone
(508) 345-4151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

715 Branch Ave
Providence, RI 02904-2248

Mailing address

715 Branch Ave
Providence, RI 02904-2248
Phone (508) 345-4151

Other identifiers 1

IdentifierTypeStateIssuer
SH23373MedicaidRI

National Provider Directory

National Provider Directory

Locations

715 Branch Ave
Providence, RI 02904
Phone (401) 525-6553

NPI Registry JSON

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1376430470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 BRANCH AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042248",
            "telephone_number": "508-345-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 BRANCH AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042248",
            "telephone_number": "508-345-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIQUE DIVERSITY INNOVATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "SHANEE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-345-4151",
        "authorized_official_credential": "LPIM"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SH23373",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.