Individual provider Active NPI

Holly Christine Tindall, APRN-CNP

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1699391086
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN02372 Issued in RI
Practice address
101 Dudley St
Providence, RI 02905-2401
Phone
(401) 274-1122
Fax
(401) 453-7571
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN02372 RI Primary

Addresses

Primary practice location

101 Dudley St
Providence, RI 02905-2401

Mailing address

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1122

Other practice location 1

186 Providence St
West Warwick, RI 02893-2508
Phone (401) 615-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210720000936 RI Practitioner - Nurse Practitioner 5294138970 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Jul 8, 2021 Accepting new patients
Quality Behavioral Health CurrentSince Sep 6, 2024 Accepting new patients
Affinity Physicians LLC CurrentSince Oct 27, 2024 Accepting new patients
Thundermist Health Center CurrentSince Jul 8, 2021 Accepting new patients
Affinity Physicians LLC. CurrentSince Oct 27, 2024 Accepting new patients
Thundermist Health Center Past Accepting new patients

Locations

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

1 River St
Wakefield, RI 02879
Phone (401) 783-0523

75 Lambert Lind Hwy
Warwick, RI 02886
Phone (401) 463-5778

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

186 Providence St
West Warwick, RI 02893
Phone (401) 615-2800

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1699391086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 Providence St",
            "address_purpose": "LOCATION",
            "city": "West Warwick",
            "state": "RI",
            "postal_code": "028932508",
            "country_code": "US",
            "telephone_number": "401-615-2800",
            "fax_number": "401-615-2805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TINDALL",
        "first_name": "HOLLY",
        "middle_name": "CHRISTINE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN02372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.