Active NPI
Thankam Paul, MD
- Pediatric Gastroenterology Physician
- Providence, RI
National Provider Identifier
1881649762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 11704
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 444-8306
- Fax
- (401) 444-8748
- NPI assigned
- May 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 11704 | RI | Primary |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
593 Eddy St
Hasbro 122
Providence, RI 02903-4923
Phone (401) 444-6484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TP56568 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11704 | RI | MD | Pediatric Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1881649762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"address_2": "HASBRO 122",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-6484",
"fax_number": "401-444-6378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-8306",
"fax_number": "401-444-8748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "THANKAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-22",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "RI",
"license": "11704",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TP56568",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.