Active NPI
Frank Hugh Fallon, D.O.
- Family Medicine Physician
- Cranston, RI
National Provider Identifier
1609861053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO0242
- Practice address
- 1592 Broad St
Cranston, RI 02905-4130 - Phone
- (401) 467-3350
- Fax
- (401) 784-6714
- NPI assigned
- Sep 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO0242 | RI | Primary |
Addresses
Primary practice location
1592 Broad St
Cranston, RI 02905-4130
Mailing address
1592 Broad St
Cranston, RI 02905-4130
Phone (401) 467-3350
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7001917 | Medicaid | RI | |
| 000753 | Other | RI | BLUE CHIP |
| 01-00143 | Other | RI | UNITED |
| 3061-4 | Other | RI | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO0242 | RI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prospect Chartercare Physicians, LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Cranston, RI
- NPI 1629493135
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1609861053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1592 BROAD ST",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029054130",
"telephone_number": "401-467-3350",
"fax_number": "401-784-6714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1592 BROAD ST",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029054130",
"telephone_number": "401-467-3350",
"fax_number": "401-784-6714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLON",
"first_name": "FRANK",
"middle_name": "HUGH",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "RI",
"license": "DO0242",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7001917",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "000753",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED",
"identifier": "01-00143",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "3061-4",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.