Individual provider Active NPI

Stephanie Ann Earle, MD

  • Family Medicine Physician
  • Woonsocket, RI
National Provider Identifier
1831621549
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD19730 Issued in RI
Practice address
450 Clinton St
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
NPI assigned
Mar 31, 2017
Last updated
Jun 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD19730 RI Primary

Addresses

Primary practice location

450 Clinton St
Woonsocket, RI 02895-3207

Mailing address

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

Other practice location 1

127 S Broadway
Yonkers, NY 10701-4006
Phone (914) 378-7586

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
I20240813000605 RI Practitioner - Family Practice 7618415381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thundermist Health CenterGroup PAC ID 1557270477, 161 clinicians

Practice addresses (Care Compare)

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19730RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Jul 29, 2024 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Jul 20, 2024 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Jul 20, 2024 Accepting new patients
Thundermist Health Center Current Accepting new patients
Thundermist Health Center CurrentSince Jul 29, 2024 Accepting new patients
Thundermist Health Center Past Accepting new patients

Locations

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA
  • Direct secure messaging: stephanieann.earle.p1@direct.saintjosephs.nextgenshare.com

Organizations & group practices 6

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1831621549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107014006",
            "country_code": "US",
            "telephone_number": "914-378-7586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARLE",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD19730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.