Tavares Pediatric Center

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

TAVARES PEDIATRIC CENTER

Doing business as

Tavares Pediatric Center

Practice address

101 Plain St
Providence, RI 02903-4828

Phone

(401) 272-7127

Fax

(401) 272-4752

NPI assigned

Nov 17, 2020

Organization subpart

No

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

Authorized official

Name

Vivian M Tavares

Title

Fin Adm

Phone

(401) 272-7127

Specialties & licenses 1

Addresses

Other names 1

• Tavares Pediatric Center Doing business as

Locations

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1598368235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034828",
            "telephone_number": "401-272-7127",
            "fax_number": "401-272-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034828",
            "telephone_number": "401-272-7127",
            "fax_number": "401-272-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVARES PEDIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "TAVARES",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FIN ADM",
        "authorized_official_telephone_number": "401-272-7127"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tavares Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hadley Tate, PA-C
• Nina Tatevian, MD PHD
• Jonathan David Tatum
• Patricia A Taubin, LMHC
• Carissa Tavares de Almeida
• Alexa Nicole Tavares, DC
• Alicia Rae Tavares, LMHC
• Cidalia Tavares
• Erica Tavares, PHARMD
• Filomena Tavares

• Intellectual Disabilities Intermediate Care Facility in Providence, RI
• Providers in Providence, RI by specialty
• Intellectual Disabilities Intermediate Care Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.