NPIMap

Individual provider Active NPI

Kathryn O. Coolidge, M.D.

  • Internal Medicine Physician
  • Cranston, RI
National Provider Identifier
1649472895
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD13218 Issued in RI
Practice address
75 Sockanosset Cross Rd
Suite 100
Cranston, RI 02920-5558
Phone
(401) 946-6200
Fax
(401) 275-1992
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD13218 RI Primary

Addresses

Primary practice location

75 Sockanosset Cross Rd
Suite 100
Cranston, RI 02920-5558

Mailing address

10 Davol SQ
Suite 400
Providence, RI 02903-4754
Phone (401) 421-4000

Other names 1

  • Kathryn E. O'Donnell Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcoolidge12556@direct.lifespan.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817001012 RI Practitioner - Internal Medicine 4688708399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

75 Sockanosset Cross Rd
Cranston, RI 02920-5558
Phone (401) 946-6200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Apr 25, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

1500 Pontiac Ave
Ste 101
Cranston, RI 02920
Phone (401) 371-0223

75 Sockanosset Cross Rd
Ste 100
Cranston, RI 02920
Phone (401) 736-4500

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

593 Eddy St
Providence, RI 02903

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Interoperability endpoints

  • Direct secure messaging: kcoolidge12556@brownhealth.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1649472895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ",
            "address_2": "SUITE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SOCKANOSSET CROSS RD",
            "address_2": "SUITE 100",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205558",
            "telephone_number": "401-946-6200",
            "fax_number": "401-275-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLIDGE",
        "first_name": "KATHRYN",
        "middle_name": "O.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD13218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcoolidge12556@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "75 Sockanosset Cross Rd",
            "address_2": "Suite 100",
            "city": "Cranston",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029205558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "O'DONNELL",
            "middle_name": "E.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.