Individual provider Active NPI

Jessica Keoviphone, LCSW

  • Clinical Social Worker
  • West Warwick, RI
National Provider Identifier
1851069769
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW04538 Issued in RI
Practice address
186 Providence St
West Warwick, RI 02893-2508
Phone
(401) 615-2800
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW02611 RI
Clinical Social Worker 1041C0700X ISW04538 RI Primary

Addresses

Primary practice location

186 Providence St
West Warwick, RI 02893-2508

Mailing address

186 Providence St
West Warwick, RI 02893-2508

Other practice location 1

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

Other practice location 2

1 River St
Wakefield, RI 02879-3214
Phone (401) 767-4100

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210921002050 RI Practitioner - Clinical Social Worker 3577960343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
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

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Oct 4, 2021 Accepting new patients
Thundermist Health Center CurrentSince Oct 4, 2021 Accepting new patients
Thundermist Health Center Current Accepting new patients

Locations

1 River St
Wakefield, RI 02879
Phone (401) 783-0523

186 Providence St
West Warwick, RI 02893
Phone (401) 615-2800

450 Clinton St
Woonsocket, RI 02895

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1851069769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 PROVIDENCE ST",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028932508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 PROVIDENCE ST",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028932508",
            "telephone_number": "401-615-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clinton St",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028953207",
            "country_code": "US",
            "telephone_number": "401-767-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 River St",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028793214",
            "country_code": "US",
            "telephone_number": "401-767-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEOVIPHONE",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW02611",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Warwick, RI

Sources for this page

Verify at the official NPI Registry.