Individual provider Active NPI

Gregory J Paquin, PH.D.

  • Psychologist
  • Providence, RI
National Provider Identifier
1710446398
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSO1759 Issued in RI
Practice address
2 Regency PLZ Ste 12
Providence, RI 02903-3143
Phone
(401) 421-1405
NPI assigned
Mar 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSO1759 RI Primary

Addresses

Primary practice location

2 Regency PLZ Ste 12
Providence, RI 02903-3143

Mailing address

2 Regency PLZ Ste 12
Providence, RI 02903-3143
Phone (401) 421-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSO1759RIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean State Assessment, LLC Psychologist Current Accepting new patients
Delta Consultants Providence/Attle Inc. Past Accepting new patients

Organizations & group practices 2

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1710446398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 REGENCY PLZ STE 12",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033143",
            "telephone_number": "401-421-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 REGENCY PLZ STE 12",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033143",
            "telephone_number": "401-421-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUIN",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PSO1759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.