Wampanoag Medical Clinic & Treatment Center

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

MD4452 Issued in RI

Legal business name

WAMPANOAG MEDICAL CLINIC & TREATMENT CENTER

Practice address

1970 Pawtucket Ave
East Providence, RI 02914-1718

Phone

(401) 438-6620

Fax

(401) 438-6621

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Juanito A Abanilla, M.D.

Title

President

Phone

(401) 438-6620

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720011018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 PAWTUCKET AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141718",
            "telephone_number": "401-438-6620",
            "fax_number": "401-438-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 PAWTUCKET AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141718",
            "telephone_number": "401-438-6620",
            "fax_number": "401-438-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAMPANOAG MEDICAL CLINIC & TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABANILLA",
        "authorized_official_first_name": "JUANITO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-438-6620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "RI",
            "license": "MD4452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Wallach, MD
• Kimberly G Wallander, R.D.
• Bobbie J. Wallick, M.A., CCC-SLP
• William Walsh, MD
• Anne S Walters, PHD
• Li Wang, M.D.
• Lauren S Ward, MD
• Bridget Ware, MS
• Michael Cecil Warren
• Waterview Ri SNF, LLC (Waterview Villa Rehabilitation & Health Care Center)

• Urgent Care Clinic/Center in East Providence, RI
• Providers in East Providence, RI by specialty
• Urgent Care Clinic/Center 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.