NPIMap

Organization Active NPI

St Joseph Health Services of Ri

  • Hospitalist Physician
  • North Providence, RI
National Provider Identifier
1831450865
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
HO00110 Issued in RI
Legal business name
ST JOSEPH HEALTH SERVICES OF RI
Practice address
200 High Service Ave
North Providence, RI 02904-5113
Phone
(401) 456-3000
NPI assigned
Jun 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Mr. Michael E Conklin Jr.
Title
SNR. Vice President, Cfo
Phone
(401) 456-3000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X HOS00110 RI
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X HOS00110 RI
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X HOS00110 RI
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X HO00110 RI Primary

Addresses

Primary practice location

200 High Service Ave
North Providence, RI 02904-5113

Mailing address

200 High Service Ave
Administration Office, Attn: R. Soares
North Providence, RI 02904-5113
Phone (401) 456-2525

Other identifiers 1

IdentifierTypeStateIssuer
HOS00110OtherRIHOSPITAL LICENSE NUMBER

Other names 1

  • HOSPITALIST GROUP Other name

National Provider Directory

National Provider Directory
Tax ID family
Psychiatric Health Serv5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 High Service Ave
Ofc Attn
North Providence, RI 02904

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1831450865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH SERVICE AVE",
            "address_2": "ADMINISTRATION OFFICE, ATTN: R. SOARES",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045113",
            "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": "200 HIGH SERVICE AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045113",
            "telephone_number": "401-456-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH HEALTH SERVICES OF RI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SNR. VICE PRESIDENT, CFO",
        "authorized_official_telephone_number": "401-456-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "RI",
            "license": "HOS00110",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "RI",
            "license": "HO00110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSE NUMBER",
            "identifier": "HOS00110",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOSPITALIST GROUP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.