NPIMap

Organization Active NPI

Thundermist Health Center

  • Dental Clinic/Center
  • Woonsocket, RI
National Provider Identifier
1457522989
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
ACF01569 Issued in RI
Legal business name
THUNDERMIST HEALTH CENTER
Practice address
25 John a Cummings Way
Woonsocket, RI 02895-3244
Phone
(401) 767-4161
Fax
(401) 767-5441
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Ckarla Agudelo
Title
Director of Credentialing
Phone
(401) 767-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X ACF01569 RI Primary

Addresses

Primary practice location

25 John a Cummings Way
Woonsocket, RI 02895-3244

Mailing address

25 John a Cummings Way Ste 203
Woonsocket, RI 02895-3244
Phone (401) 767-4100

Other practice location 1

5 Washington St
West Warwick, RI 02893-4927
Phone (401) 615-2804

Other practice location 2

1 River St
Wakefield, RI 02879-3214
Phone (401) 783-5646

Other identifiers 1

IdentifierTypeStateIssuer
TH02580MedicaidRI

National Provider Directory

National Provider Directory
Tax ID family
Thundermist Health Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1457522989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 JOHN A CUMMINGS WAY STE 203",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953244",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JOHN A CUMMINGS WAY",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953244",
            "telephone_number": "401-767-4161",
            "fax_number": "401-767-5441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Washington St",
            "address_purpose": "LOCATION",
            "city": "West Warwick",
            "state": "RI",
            "postal_code": "028934927",
            "country_code": "US",
            "telephone_number": "401-615-2804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 River St",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028793214",
            "country_code": "US",
            "telephone_number": "401-783-5646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THUNDERMIST HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "AGUDELO",
        "authorized_official_first_name": "CKARLA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "401-767-4100"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "RI",
            "license": "ACF01569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH02580",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.