Charlesgate Nursing Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

LTC00621 Issued in RI

Legal business name

CHARLESGATE NURSING CENTER

Practice address

100 Randall St
Providence, RI 02904-2723

Phone

(401) 861-5858

Fax

(401) 861-2540

NPI assigned

Oct 24, 2005

Organization subpart

No

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

Authorized official

Name

Miss Lucille Massemino, RN,NHA

Title

Administrator

Phone

(401) 861-5858

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1881684736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RANDALL ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042723",
            "telephone_number": "401-861-5858",
            "fax_number": "401-861-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RANDALL ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042723",
            "telephone_number": "401-861-5858",
            "fax_number": "401-861-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESGATE NURSING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "MASSEMINO",
        "authorized_official_first_name": "LUCILLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-861-5858",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN,NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "LTC00621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4105052",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Street Community Center
• Amos Charles
• Cathy Maria Charles, MD, MPH
• Machel Charles, PA
• Nerssie Charles
• Charlesgate Senior Living Center
• Patrice Lena Charnley, RN, C, CARN
• Margaret M Charpentier, PHARM.D.
• Louis Charron, LICSW
• Chartercare Associates in Primary Care Medicine, LLC

• Skilled Nursing Facility in Providence, RI
• Providers in Providence, RI by specialty
• Skilled Nursing Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.

Verify at the official NPI Registry.