NPIMap

Organization Active NPI

Minuteclinic Diagnostic of Rhode Island, LLC

  • Family Nurse Practitioner
  • Woonsocket, RI
National Provider Identifier
1649511841
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MINUTECLINIC DIAGNOSTIC OF RHODE ISLAND, LLC
Practice address
1054 Cass Ave
Woonsocket, RI 02895-4935
Phone
(866) 389-2727
NPI assigned
Mar 13, 2013
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MINUTECLINIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Deborah Jean Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

1054 Cass Ave
Woonsocket, RI 02895-4935

Mailing address

PO Box 772
Minuteclinic Credentialing-Mc2295
Woonsocket, RI 02895-0784
Phone (866) 389-2727

Other practice location 1

120 Eddie Dowling Hwy
North Smithfield, RI 02896-8214
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141209002236 RI Part B Supplier - Clinic/Group Practice 8224350863 Receives reassigned benefits from 46 practitioners
Practice locations: Westerly, RI; Woonsocket, RI; Wakefield, RI; Providence, RI; North Smithfield, RI; East Greenwich, RI; Cranston, RI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
41D2074120Minuteclinic Diagnostic of Rhode Island, LLC120 Eddie Dowling Highway, North Smithfield, RI 02896Certificate of waiverMar 2, 2028

National Provider Directory

National Provider Directory
Part of
Minuteclinic

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1649511841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "address_2": "MINUTECLINIC CREDENTIALING-MC2295",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954935",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Eddie Dowling Hwy",
            "address_purpose": "LOCATION",
            "city": "North Smithfield",
            "state": "RI",
            "postal_code": "028968214",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC OF RHODE ISLAND, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINUTECLINIC, LLC",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.