Organization Active NPI

Roger Williams Medical Center

  • Surgical Oncology Physician
  • Providence, RI
National Provider Identifier
1760736557
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
HOD00108 Issued in RI
Legal business name
ROGER WILLIAMS MEDICAL CENTER
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 456-2000
NPI assigned
Nov 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Authorized official

Name
Kenneth H. Belcher
Title
President, Ceo
Phone
(401) 456-2025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X HOS00108 RI
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X HOD00108 RI Primary

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

825 Chalkstone Ave
N. Campus Business Office, Attn: R. Soares
Providence, RI 02908-4728
Phone (401) 456-2525

Other identifiers 2

IdentifierTypeStateIssuer
HOS00108OtherRIHOSPITAL LICENSE NUMBER
RO91282MedicaidRI

Other names 1

  • Roger Williams Surgical Oncology Group Other name

National Provider Directory

National Provider Directory

Locations

1 Office Pkwy
Ste 301
East Providence, RI 02914
Phone (401) 456-3000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1760736557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "address_2": "N. CAMPUS BUSINESS OFFICE, ATTN: R. SOARES",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2525",
            "fax_number": "401-456-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER WILLIAMS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "401-456-2025"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "RI",
            "license": "HOS00108",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "RI",
            "license": "HOD00108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSE NUMBER",
            "identifier": "HOS00108",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RO91282",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roger Williams Surgical Oncology Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 18, 2013; 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.