Individual provider Active NPI

Susan M Paquette, RN-CNS

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Middletown, RI
National Provider Identifier
1639198302
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
RN27310 Issued in RI
Practice address
127 Johnny Cake Hill Rd
Middletown, RI 02842-5674
Phone
(401) 846-1213
Fax
(401) 324-6251
NPI assigned
Jul 19, 2006
Last updated
Mar 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X PPNS00074 RI
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X RN27310 RI Primary

Addresses

Primary practice location

127 Johnny Cake Hill Rd
Middletown, RI 02842-5674

Mailing address

127 Johnny Cake Hill Rd
Middletown, RI 02842-5674
Phone (401) 846-1213

Other identifiers 1

IdentifierTypeStateIssuer
SP07734MedicaidRI

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

State licenses

LicenseStateTypeSpecialty
RN27310RIMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
PPNS00074RIMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Healthcare Inc PastSince May 9, 2021 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, 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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1639198302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 JOHNNY CAKE HILL RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425674",
            "telephone_number": "401-846-1213",
            "fax_number": "401-324-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 JOHNNY CAKE HILL RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425674",
            "telephone_number": "401-846-1213",
            "fax_number": "401-324-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN-CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "RI",
            "license": "PPNS00074",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "RI",
            "license": "RN27310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP07734",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.