Ccsri, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

CCSRI, LLC

Practice address

650 Ten Rod Rd
North Kingstown, RI 02852-4238

Phone

(301) 809-4000

NPI assigned

May 18, 2018

Organization subpart

No

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

Authorized official

Name

Veronica Pickens

Title

Avp, Compliance and Delegation

Phone

(301) 809-4000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1598255168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 COLLINGTON RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207162259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 TEN ROD RD",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524238",
            "telephone_number": "301-809-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCSRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "PICKENS",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "AVP, COMPLIANCE AND DELEGATION",
        "authorized_official_telephone_number": "301-809-4000"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.