Individual provider Active NPI

Jennifer L Eaton, M.D.

  • Reproductive Endocrinology Physician
  • Providence, RI
National Provider Identifier
1821119074
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
MD17109 Issued in RI
Practice address
90 Plain St
Providence, RI 02903-4817
Phone
(401) 441-5336
NPI assigned
Apr 3, 2007
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD17109 RI
Reproductive Endocrinology Physician 207VE0102X MD17109 RI Primary

Addresses

Primary practice location

90 Plain St
Providence, RI 02903-4817

Mailing address

90 Plain St
Providence, RI 02903-4817
Phone (401) 441-5336

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeaton@wih.cernerdirect.carene.org Direct

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
I20200625002855 RI Practitioner - Obstetrics/Gynecology 8820198518 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17109RIMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jul 27, 2020 Accepting new patients
Affinity Physicians LLC. Obstetrics & Gynecology CurrentSince Jul 27, 2020 Accepting new patients

Locations

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: jeaton@wih.cernerdirect.carene.org
  • Direct secure messaging: jleaton@direct.carene.org

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1821119074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PLAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034817",
            "telephone_number": "401-441-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PLAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034817",
            "telephone_number": "401-441-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "MD17109",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "RI",
            "license": "MD17109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeaton@wih.cernerdirect.carene.org",
            "affiliation": "N",
            "endpointDescription": "direct messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "90 Plain St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029034817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.