Individual provider Active NPI

Colleen Gregory, PHD

  • Psychologist
  • Woonsocket, RI
National Provider Identifier
1609977420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS00695 Issued in RI
Practice address
55 John a Cummings Way
Woonsocket, RI 02895-3247
Phone
(401) 235-7000
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS00695 RI Primary

Addresses

Primary practice location

55 John a Cummings Way
Woonsocket, RI 02895-3247

Mailing address

PO Box 1512
Kingston, RI 02881-0491
Phone (401) 783-2864

Other identifiers 4

IdentifierTypeStateIssuer
6131098OtherRIUNITED HEALTH
0000030459OtherRIBLUE CROSS
407648OtherRIBLUE CHIP
CG19463MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081201000429 RI Practitioner - Clinical Psychologist 3375604960 Reassigns benefits to 1 organization
Practice locations: North Kingstown, RI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS00695RIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Alliance CurrentSince Dec 5, 2008 Accepting new patients

Locations

55 John a Cummings Way
Woonsocket, RI 02895
Phone (401) 235-7021

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, 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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609977420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1512",
            "city": "KINGSTON",
            "state": "RI",
            "postal_code": "028810491",
            "telephone_number": "401-783-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 JOHN A CUMMINGS WAY",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953247",
            "telephone_number": "401-235-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS00695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "6131098",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0000030459",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "407648",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CG19463",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.