NPIMap

Organization Active NPI

Genesis

  • Skilled Nursing Facility
  • Pawtucket, RI
National Provider Identifier
1831485689
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
PTA00767 Issued in RI
Legal business name
GENESIS
Practice address
70 Gill Ave
Pawtucket, RI 02861-4315
Phone
(401) 722-7900
NPI assigned
Jun 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Authorized official

Name
Debra Lynn Collette, PTA
Title
Physical Therapy Assistant
Phone
(401) 722-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X PTA00767 RI Primary

Addresses

Primary practice location

70 Gill Ave
Pawtucket, RI 02861-4315

Mailing address

70 Gill Ave
Pawtucket, RI 02861-4315
Phone (401) 722-7900

National Provider Directory

National Provider Directory
Tax ID family
Genesis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1831485689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GILL AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028614315",
            "telephone_number": "401-722-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GILL AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028614315",
            "telephone_number": "401-722-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "COLLETTE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHYSICAL THERAPY ASSISTANT",
        "authorized_official_telephone_number": "401-722-7900",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "PTA00767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.