Edyta Reis, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

RN54971 Issued in RI

Practice address

101-103 Bacon Street
Pawtucket, RI 02860

Phone

(401) 722-3560

Fax

(401) 722-5280

NPI assigned

Jun 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932
  NPD (past)

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1790279719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101-103 BACON STREET",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-722-3560",
            "fax_number": "401-722-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101-103 Bacon Street",
            "address_purpose": "LOCATION",
            "city": "Pawtucket",
            "state": "RI",
            "postal_code": "02860",
            "country_code": "US",
            "telephone_number": "401-722-3560",
            "fax_number": "401-722-5280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIS",
        "first_name": "EDYTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "RI",
            "license": "RN54971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1821078932",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewec1@lifespan.org",
            "affiliation": "N",
            "endpointDescription": "ewec1@lifespan.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "609 High St",
            "city": "Central Falls",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028633117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sydney Michelle Raymond, M.S., BCBA, LBA
• Re-Focus Inc.
• Frederic Gary Reamer
• Rebecca Babcock Fenerci PHD LLC (Compassionate Healing)
• Chaitanya Reddy, DO
• Lisa Ann Renard, RPT
• Donna Renshaw
• Heather Lee Reny
• Resources for Human Development
• Resources for Human Development Inc.

• Community Health Registered Nurse in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Community Health Registered Nurse in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.