Prospect Chartercare RWMC, LLC

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

License

HOS00108 Issued in RI

Legal business name

PROSPECT CHARTERCARE RWMC, LLC

Doing business as

Roger Williams Medical Center

Practice address

825 Chalkstone Ave
Providence, RI 02908-4728

Phone

(401) 456-2000

Fax

(401) 456-2029

NPI assigned

Feb 27, 2014

Last updated

Jan 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Jon Elders

Title

Secretary

Phone

(714) 788-1249

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Roger Williams Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477978476. Details of each certification follow.

• CCN 41S004 Hospital · Details

Hospital certification: CCN 41S004

Legal name

PROSPECT CHARTERCARE RWMC, LLC

Doing business as

ROGER WILLIAMS MEDICAL CENTER

Organization structure

LLCProprietary

Incorporated

Aug 21, 2013 in RI

Enrollment address

825 Chalkstone Ave
Providence, RI 29084735
Hospital Psychiatric Unit

Hospital subgroups

General, Acute care, Psychiatric, Psychiatric unit

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1013332014

  Unit of hospital

  Provider of Services

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1013332014

  0547492696

  Same PAC ID
• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1285059287

  0547492696

  Same PAC ID

Locations

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Prospect Chartercare Home Health and Hospice, LLC

  • Home Health Agency
  • Providence, RI
  • NPI 1811402100

  5% Or Greater Indirect Ownership Interest

  CMS ownership

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Prospect Chartercare Home Health and Hospice, LLC

  • Home Health Agency
  • Providence, RI
  • NPI 1811402100

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Chartercare, LLC, Prospect East Holdings, Inc., Prospect Medical Holdings Inc

  CMS ownership
• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1013332014

  Chamber Inc, Chartercare Community Board, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding, Inc., Prospect Chartercare, LLC, Prospect East Holdings, Inc., Prospect Medical Holdings Inc

  CMS ownership
• Prospect Chartercare Sjhsri, LLC

  dba Southern New England Rehabilitation Center

  • Rehabilitation Hospital Unit
  • North Providence, RI
  • NPI 1205251204

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding, Inc., Prospect Chartercare, LLC, Prospect East Holdings, Inc., Prospect Medical Holdings Inc

  CMS ownership
• Prospect Chartercare Sjhsri, LLC

  dba St. Joseph Health Center

  • Psychiatric Hospital Unit
  • North Providence, RI
  • NPI 1396160396

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding, Inc., Prospect Chartercare, LLC, Prospect East Holdings, Inc., Prospect Medical Holdings Inc

  CMS ownership
• Prospect Chartercare Sjhsri, LLC

  dba Our Lady of Fatima Hospital

  • General Acute Care Hospital
  • North Providence, RI
  • NPI 1871918870

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding, Inc., Prospect Chartercare, LLC, Prospect East Holdings, Inc., Prospect Medical Holdings Inc

  CMS ownership
• Alta Los Angeles Hospitals, Inc.

  dba Los Angeles Comm Hosp, Norwalk Comm Hosp & LA Comm Hosp at Bellflower

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922001809

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc

  CMS ownership
• Alta Newport Hospital, LLC

  dba Foothill Regional Medical Center

  • Pediatric Skilled Nursing Facility
  • Tustin, CA
  • NPI 1689096406

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc

  CMS ownership
• Prospect Waterbury Home Health, Inc.

  dba VNA Health at Home

  • Home Health Agency
  • Watertown, CT
  • NPI 1265880413

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc

  CMS ownership
• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc

  CMS ownership
• Southern California Healthcare System, Inc

  dba Southern California Hospital at Hollywood, at Van Nuys, at Culver City

  • General Acute Care Hospital
  • Hollywood, CA
  • NPI 1023010113

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc

  CMS ownership
• Southern California Healthcare System, Inc

  dba Southern California Hospital at Culver City

  • Rehabilitation Hospital Unit
  • Culver City, CA
  • NPI 1861744138

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc

  CMS ownership
• Southern California Healthcare System, Inc

  dba Southern California Hospital at Culver City

  • Skilled Nursing Facility
  • Culver City, CA
  • NPI 1922350206

  Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc

  CMS ownership

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1477978476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000",
            "fax_number": "401-456-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000",
            "fax_number": "401-456-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT CHARTERCARE RWMC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "ELDERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-788-1249"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "RI",
            "license": "HOS00108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4100004",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roger Williams Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roger Williams Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prospect Chartercare Home Health and Hospice, LLC
• Prospect Chartercare Physicians LLC (Chartercare Medical Assoc. Infusion Center)
• Prospect Chartercare RWMC, LLC (Roger Williams Medical Center)
• Prospect Chartercare RWMC, LLC (Roger Williams Medical Center)
• Prospect Chartercare RWMC, LLC (Roger Williams Medical Center)
• Prospect Chartercare RWMC, LLC
• Prospect Chartercare RWMC, LLC (CharterCARE Home Health Services)
• Prospect Chartercare Sjhsri, LLC (St. Joseph Dental Associates)
• Anne Prosser, LMT
• Prosthodontics, LTD

• Psychiatric Hospital Unit in Providence, RI
• Providers in Providence, RI by specialty
• Psychiatric Hospital Unit in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.