NPIMap

Organization Active NPI

Roger Williams Medical Center

Doing business as Roger Williams Physician Assistant Group

  • Surgery Physician
  • Providence, RI
National Provider Identifier
1518987981
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ROGER WILLIAMS MEDICAL CENTER
Doing business as
Roger Williams Physician Assistant Group
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 456-2000
Fax
(401) 456-6718
NPI assigned
Jul 20, 2006
Last updated
Dec 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Authorized official

Name
Kenneth Belcher
Title
Predident, Ceo
Phone
(401) 456-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

825 Chalkstone Ave
N. Campus Business Office
Providence, RI 02908-4728
Phone (401) 456-2000

Other identifiers 1

IdentifierTypeStateIssuer
9002981MedicaidRI

Other names 1

  • ROGER WILLIAMS PHYSICIAN ASSISTANT GROUP Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1518987981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "address_2": "N. CAMPUS BUSINESS OFFICE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000",
            "fax_number": "401-456-6718"
        },
        {
            "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": "401-456-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER WILLIAMS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PREDIDENT, CEO",
        "authorized_official_telephone_number": "401-456-2000"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9002981",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROGER WILLIAMS PHYSICIAN ASSISTANT GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.