Hattie Ide Chaffee Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

223 Issued in RI

Legal business name

HATTIE IDE CHAFFEE NURSING HOME INC

Practice address

200 Wampanoag TRL
Riverside, RI 02915-2206

Phone

(401) 434-1520

Fax

(401) 438-8494

NPI assigned

Feb 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah M Griffin

Title

Administrator

Phone

(401) 434-1520

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700912458. Details of each certification follow.

• CCN 415002 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 415002

Legal name

HATTIE IDE CHAFFEE NURSING HOME INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1981

Last certification

Jun 17, 2024

Beds

69

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 23, 1948 in RI

Enrollment address

200 Wampanoag TRL
Riverside, RI 02915-2206

Nursing home name

HATTIE IDE CHAFFEE HOME

Listed as

Hattie Ide Chaffee HomeCCN 415002 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1981

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6967.1 residents per day on average

Penalties (3 years)

2Fines totaling $40,295

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Ralph F Santoro, M.D.

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1710098249

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Vera A. Depalo, MD

  • Pulmonary Disease Physician
  • Cranston, RI
  • NPI 1659354546

  Nursing home

  Care Compare affiliation
• Jun O Parks, M. D.

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1093079006

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700912458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152206",
            "telephone_number": "401-434-1520",
            "fax_number": "401-438-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152206",
            "telephone_number": "401-434-1520",
            "fax_number": "401-438-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIE IDE CHAFFEE NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-434-1520",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "71-09045",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5024-7",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP PROVIDER #",
            "identifier": "401299",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4105002",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jessica J Harris, APRN
• Dawn M Harty
• Jessica Olingy Hay, NP
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• Karen Marie Healy, R.N
• Kasheida Hector, LICSW

• Skilled Nursing Facility in Riverside, RI
• Providers in Riverside, RI by specialty
• Skilled Nursing Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.