Active NPI
Enid Fitzpatrick
- Pharmacist
- Providence, RI
National Provider Identifier
1629355011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03750
- Practice address
- 295 Academy Ave
Providence, RI 02908 - Phone
- (401) 273-7675
- NPI assigned
- Nov 14, 2011
- Last updated
- Nov 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03750 | RI | Primary |
| Pharmacist | 183500000X | 22308 | MA |
Addresses
Primary practice location
295 Academy Ave
Providence, RI 02908
Mailing address
25 Jacqueline Dr
Providence, RI 02909
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22308 | MA | MD | Pharmacist |
| 03750 | RI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
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, 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": "1321228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321228800000",
"number": "1629355011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 JACQUELINE DR",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 ACADEMY AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02908",
"telephone_number": "401-273-7675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZPATRICK",
"first_name": "ENID",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-14",
"last_updated": "2011-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "03750",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "22308",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.