Individual provider Active NPI

Julie K Rousseau, NP

  • Nurse Practitioner
  • Warwick, RI
National Provider Identifier
1427064542
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNPP37217 Issued in RI
Practice address
857 Post Rd
Warwick, RI 02888-3360
Phone
(401) 467-3115
Fax
(401) 785-8468
NPI assigned
Jul 31, 2006
Last updated
Dec 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNPP37217 RI Primary

Addresses

Primary practice location

857 Post Rd
Warwick, RI 02888-3360

Mailing address

857 Post Rd
Warwick, RI 02888-3360
Phone (401) 467-3115

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
I20050223000598 RI Practitioner - Nurse Practitioner 8527011121 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNPP37217RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare Physicians, LLC CurrentSince Apr 6, 2020 Accepting new patients
State of Rhode Island Past Accepting new patients

Locations

1681 Cranston St
Cranston, RI 02920
Phone (401) 944-6889

1 Office Pkwy
East Providence, RI 02914
Phone (401) 270-7110

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

857 Post Rd
Warwick, RI 02888
Phone (401) 467-3115

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1427064542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883360",
            "telephone_number": "401-467-3115",
            "fax_number": "401-785-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883360",
            "telephone_number": "401-467-3115",
            "fax_number": "401-785-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEAU",
        "first_name": "JULIE",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "CNPP37217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.