Jeremy Agu Parker, M.D.

Primary specialty

Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X

License

MD18857 Issued in RI

Practice address

825 Chalkstone Ave
Providence, RI 02908-4728

Phone

(401) 456-2000

NPI assigned

Apr 9, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prospect Chartercare RWMC, LLCGroup PAC ID 0547492696, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Roger Williams Medical Center Hospital, Providence, RI, CCN 410004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1285059287
  Medicare reassignment Care Compare group NPD
• Chartercare Our Lady of Fatima Hospital

  dba Our Lady of Fatima Hospital

  • Internal Medicine Physician
  • North Providence, RI
  • NPI 1346079209

  Neurology

  Medicare reassignment NPD
• Chartercare Roger Williams Medical Center

  dba Roger Williams Medical Center

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1649009507
  Medicare reassignment NPD
• Prospect Chartercare Sjhsri, LLC

  dba Our Lady of Fatima Hospital

  • Internal Medicine Physician
  • North Providence, RI
  • NPI 1588089759

  Neurology

  Medicare reassignment NPD
• Torchlight Wellness LLC

  • Psychosomatic Medicine Physician
  • Pawtucket, RI
  • NPI 1720876147
  NPD Authorized official
• Chartercare Our Lady of Fatima Hospital

  dba Our Lady of Fatima Hospital

  • Cardiovascular Disease Physician
  • North Providence, RI
  • NPI 1255160115
  NPD
• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • Cardiovascular Disease Physician
  • Providence, RI
  • NPI 1326463548
  NPD
• Prospect Chartercare Sjhsri, LLC

  dba Our Lady of Fatima Hospital

  • General Acute Care Hospital
  • North Providence, RI
  • NPI 1871918870
  NPD
• Roger Williams Medical Center

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1649278250
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1013332014
  Care Compare affiliation

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1780027888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000"
        },
        {
            "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": {
        "last_name": "PARKER",
        "first_name": "JEREMY",
        "middle_name": "AGU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "RI",
            "license": "MD18857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Park, M.D.
• Joel T Park II, MD
• Elaine K. Parker-Williams, ARNP
• Cassandra Susan Parker
• Daniel Allen Parker Jr., M.S.
• Meghann Parker
• Robert Parker, M.D.
• Tarrah Parkman, LCSW
• Philip David Parks II, MD, MPH, MOCCH
• James Michael Parra II, MD

• Psychosomatic Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Psychosomatic Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.