Atmed Primary Care Inc.

Key facts

NPI

1417099797

Entity type

Organization (NPI type 2)

Primary specialty

Non-Pharmacy Dispensing Site 332900000X

License

MD09755 (RI)

Legal business name

ATMED PRIMARY CARE INC.

Practice address

1526 Atwood Ave
Suite 105
Johnston, RI 02919-3289

Phone

(401) 272-5468

NPI assigned

Feb 13, 2007

Organization subpart

Yes

Parent organization (as reported)

MEDVANTX, INC.

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Practitioners 1

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

• Dian Joan Cullion, PA-C Medical Physician Assistant · Johnston, RI · NPI 1972551489
  NPD (past)

National Provider Directory

Part of

Tri - State Medical Group Inc

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 16, 2012.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1417099797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 ATWOOD AVE",
            "address_2": "SUITE 105",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193289",
            "telephone_number": "401-272-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATMED PRIMARY CARE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "RI",
            "license": "MD09755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

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• Ara-Johnston Dialysis LLC
• McKayla Arbige, MASTERS
• Michel Albert Arcand, M.D.
• Atmed Primary Care Inc
• Atmed Treatment Center Inc
• Atmed Treatment Center, Inc.
• Atwood Gastroenterology Services, LTD.
• Atwood Medical Associates LTD
• Atwood Orthopedic Assoc

All providers in Johnston, RI · Non-Pharmacy Dispensing Site in Rhode Island