NPIMap

Organization Active NPI

Blackstone Medical Center, Inc.

  • Occupational Medicine Physician
  • Woonsocket, RI
National Provider Identifier
1881949014
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
00117 Issued in RI
Legal business name
BLACKSTONE MEDICAL CENTER, INC.
Practice address
115 Cass Ave
Woonsocket, RI 02895-4705
Phone
(401) 769-4100
Fax
(401) 769-1744
NPI assigned
Jul 13, 2012
Organization subpart
Yes
Parent organization
STEWARD MEDICAL HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Mr. James Renna
Title
Cfo
Phone
(617) 419-4772

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2083X0100X 00117 RI Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 00117 RI

Addresses

Primary practice location

115 Cass Ave
Woonsocket, RI 02895-4705

Mailing address

196 Cass Ave
Woonsocket, RI 02895-4712
Phone (401) 769-4100

Other names 1

  • Blackstone Medical Center Occupational Medicine Department Other name

National Provider Directory

National Provider Directory
Tax ID family
Blackstone Medical Center Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1881949014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954712",
            "telephone_number": "401-769-4100",
            "fax_number": "401-765-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954705",
            "telephone_number": "401-769-4100",
            "fax_number": "401-769-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEWARD MEDICAL HOLDINGS, LLC",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "RENNA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-419-4772",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "RI",
            "license": "00117",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "00117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackstone Medical Center Occupational Medicine Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.