Coventry Primary Care Associates, Inc.

Key facts

NPI: 1659418671
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
Legal business name: COVENTRY PRIMARY CARE ASSOCIATES, INC.
Practice address: 1620 Nooseneck Hill Rd
Coventry, RI 02816-6705
Phone: (401) 821-6981
Fax: (401) 821-1352
NPI assigned: Jan 31, 2007
Organization subpart: No

Authorized official

Name: Dr. Timothy Joseph Manown, M.D.
Title: President
Phone: (401) 821-6981

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207R00000X			Yes

Addresses

Primary practice location

1620 Nooseneck Hill Rd
Coventry, RI 02816-6705

Mailing address

1620 Nooseneck Hill Rd
Coventry, RI 02816-6705
Phone (401) 821-6981

Other identifiers

Identifier	Type	State	Issuer
CP46184	Medicaid	RI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 6, 2015.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1659418671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 NOOSENECK HILL RD",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166705",
            "telephone_number": "401-821-6981",
            "fax_number": "401-821-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 NOOSENECK HILL RD",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166705",
            "telephone_number": "401-821-6981",
            "fax_number": "401-821-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENTRY PRIMARY CARE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "MANOWN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-821-6981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CP46184",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coventry, RI

All providers in Coventry, 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 Oct 6, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.