Individual provider Active NPI

Courtney Briar Pichardo, CRNA

  • Certified Registered Nurse Anesthetist
  • Warwick, RI
National Provider Identifier
1700423324
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
127747 Issued in RI
Practice address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone
(401) 737-7000
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 127747 RI Primary

Addresses

Primary practice location

455 Toll Gate Rd
Warwick, RI 02886-2759

Mailing address

84 Chestnut Ave
Narragansett, RI 02882-6114
Phone (401) 486-8920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200131001008 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709212202 Reassigns benefits to 2 organizations
I20200131001361 RI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709212202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Narragansett Bay Anesthesia LLCGroup PAC ID 5991774929, 95 clinicians

Practice addresses (Care Compare)

440 Swansea Mall Dr
Swansea, MA 02777-4114
Phone (508) 324-1171

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7000

Hospital & facility affiliations

  • South County Hospital Inc Hospital, Wakefield, RI, CCN 410008
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
127747RIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Narragansett Bay Anesthesia, LLC Single Specialty CurrentSince Jan 1, 2020 Accepting new patients
Steward Medical Group, Inc Single Specialty CurrentSince Jan 21, 2020 Accepting new patients
Steward Medical Group, Inc Single Specialty CurrentSince Jan 21, 2020 Accepting new patients

Locations

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

77 Warren St
Fl 4
Brighton, MA 02135
Phone (617) 562-5450

440 Swansea Mall Dr
Swansea, MA 02777
Phone (508) 324-1171

690 Canton St
Ste 325
Westwood, MA 02090
Phone 7814077713307

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

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

Organizations & group practices 3

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1700423324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 CHESTNUT AVE",
            "city": "NARRAGANSETT",
            "state": "RI",
            "postal_code": "028826114",
            "telephone_number": "401-486-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHARDO",
        "first_name": "COURTNEY",
        "middle_name": "BRIAR",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "127747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.