Individual provider Active NPI

Bettina Weis Killion, M.D.

  • Internal Medicine Physician
  • Middletown, RI
National Provider Identifier
1750305330
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD15676 Issued in RI
Practice address
850 Aquidneck Ave
Middletown, RI 02842-7280
Phone
(401) 846-0055
Fax
(401) 842-0963
NPI assigned
Jul 27, 2006
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD15676 RI Primary

Addresses

Primary practice location

850 Aquidneck Ave
Middletown, RI 02842-7280

Mailing address

10 Davol SQ
Ste 400
Providence, RI 02903-4754
Phone (401) 421-4000

Other identifiers 1

IdentifierTypeStateIssuer
1750305330MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkillion220854@direct.lifespan.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170308000243 RI Practitioner - Internal Medicine 8729092473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD15676RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Apr 25, 2021 Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

850 Aquidneck Ave
Middletown, RI 02842
Phone (401) 846-0055

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1750305330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ",
            "address_2": "STE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 AQUIDNECK AVE",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028427280",
            "telephone_number": "401-846-0055",
            "fax_number": "401-842-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLION",
        "first_name": "BETTINA",
        "middle_name": "WEIS",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD15676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750305330",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkillion220854@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "850 Aquidneck Ave",
            "city": "Middletown",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028427280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.