Chartercare Roger Williams Medical Center
Organization Active NPI Internal Medicine Physician · Providence, RI
NPI 1649009507 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1649009507
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- CHARTERCARE ROGER WILLIAMS MEDICAL CENTER
- Practice address
- 825 Chalkstone Ave
Providence, RI 02908-4728 - Phone
- (401) 456-2000
- Fax
- (401) 456-2029
- NPI assigned
- Jul 30, 2024
- Organization subpart
- No
Authorized official
- Name
- Jeffrey Liebman
- Title
- Ceo
- Phone
- (401) 456-2001
Practitioners 109
-
Joanna Abi Chebl, MD
-
Ali A Akhtar, M.D.
-
Gregory G Allen, D.O.
-
Cynthia M Alves, MD
-
Kendra Apici, LICSW
-
Nebyou Belay, MD
-
Tyler Carden, RD, LDN
-
Jessica Belli Castronovo, LICSW, MSW, MPH, CCM
-
Alice M Colon, LICSW
-
Gerald A Colvin, DO
-
Nathalia Doobay, DPM
-
Andria Duarte, PMHNP-BC
-
Alex Etienne, MD
-
Ralph Eugene, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250730002838 | RI | Part B Supplier - Clinic/Group Practice | 1456868736 |
Receives reassigned benefits from 109 practitioners Practice locations: East Providence, RI; Greenville, RI; Johnston, RI; Pawtucket, RI; Providence, RI; Riverside, RI; Warren, RI; East Greenwich, RI |
National Provider Directory
Locations
1539 Atwood Ave
Ste 125
Johnston, RI 02919
Phone (401) 272-9880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Addiction (Substance Use Disorder) Psychologist |
103TA0400X | |||
| Social Worker |
104100000X | |||
| Clinical Social Worker |
1041C0700X | |||
| Specialist |
174400000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Addiction Medicine (Internal Medicine) Physician |
207RA0401X | |||
| Hematology & Oncology Physician |
207RH0003X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Addiction Psychiatry Physician |
2084P0802X | |||
| Surgery Physician |
208600000X | |||
| Surgical Oncology Physician |
2086X0206X | |||
| Foot & Ankle Surgery Podiatrist |
213ES0103X |
Addresses
Primary practice location
825 Chalkstone Ave
Providence, RI 02908-4728
Mailing address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000
Other names
- Roger Williams Medical Center
Other providers in Providence, RI
- Chartercare Associates in Primary Care Medicine, LLC
- Chartercare Health Partners
- Chartercare Home Health and Hospice, LLC
- Chartercare Roger Williams Medical Center
- Chartercare Roger Williams Medical Center
- Chartercare Roger Williams Medical Center
- Ashley Leslie Chartier
- Debra B Charzewski
- Aquilla Jane Chase
- Kristen Chase
All providers in Providence, RI · Internal Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.