Individual provider Active NPI

Patricia M Reposa, APRN BC

  • Clinical Nurse Specialist
  • Warwick, RI
National Provider Identifier
1619059425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
RN19548 Issued in RI
Practice address
300 Centerville Road
Summit West Suite 101
Warwick, RI 02886
Phone
(401) 732-4500
Fax
(401) 732-7766
NPI assigned
Oct 20, 2006
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
Clinical Nurse Specialist 364S00000X RN19548 RI Primary

Addresses

Primary practice location

300 Centerville Road
Summit West Suite 101
Warwick, RI 02886

Mailing address

300 Centerville Road
Summit West Suite 101
Warwick, RI 02886
Phone (401) 732-4500

Other identifiers 2

IdentifierTypeStateIssuer
400577OtherRIBLUE CHIP
222147OtherRIBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180816000113 TN Practitioner - Certified Clinical Nurse Specialist (CNS) 1658620125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Yale University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Power of Three PsychiatryGroup PAC ID 5890129464, 6 clinicians

Practice addresses (Care Compare)

301 Clark St
Knoxville, TN 37921-6328
Phone (865) 588-1718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN19548RIMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Power of Three Psychiatry CurrentSince Jan 1, 2020 Accepting new patients
West Bay Psychiatric Associates Past Accepting new patients

Locations

301 Clark St
Knoxville, TN 37921
Phone (865) 588-1718

305 Westfield Rd
Knoxville, TN 37919
Phone (865) 409-5001

Interoperability endpoints

  • Direct secure messaging: havenfamilypsychiatry.patriciareposa@134921.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619059425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CENTERVILLE ROAD",
            "address_2": "SUMMIT WEST SUITE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-732-4500",
            "fax_number": "401-732-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CENTERVILLE ROAD",
            "address_2": "SUMMIT WEST SUITE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-732-4500",
            "fax_number": "401-732-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPOSA",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "APRN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "RI",
            "license": "RN19548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "400577",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "222147",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.