Individual provider Active NPI

Melissa Robidoux, DPT

  • Physical Therapist
  • North Providence, RI
National Provider Identifier
1518243120
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02401 Issued in RI
Practice address
1401 Douglas Ave
North Providence, RI 02904-4058
Phone
(401) 435-4540
Fax
(401) 434-4521
NPI assigned
Oct 26, 2011
Last updated
Dec 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT02401 RI Primary

Addresses

Primary practice location

1401 Douglas Ave
North Providence, RI 02904-4058

Mailing address

4 Richmond SQ Ste 200
Providence, RI 02906-5117
Phone (401) 433-4172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000227 RI Practitioner - Physical Therapist in Private Practice 8022276203 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT02401RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Jul 22, 2013 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Jul 22, 2013 Accepting new patients

Locations

5750 Post Rd
#1A
East Greenwich, RI 02818
Phone (401) 885-2821

1401 Douglas Ave
North Providence, RI 02904
Phone (401) 435-4540

21 Division St
Pawtucket, RI 02860

4 Richmond Sq
Ste 200
Providence, RI 02906

41 Sanderson Rd
Ste 101
Smithfield, RI 02917
Phone (401) 349-4540

426 Metacom Ave
Warren, RI 02885
Phone (401) 903-2167

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": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1518243120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DOUGLAS AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044058",
            "telephone_number": "401-435-4540",
            "fax_number": "401-434-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBIDOUX",
        "first_name": "MELISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.