NPIMap

Organization Active NPI

Prime Healthcare Services - Landmark ,LLC

  • Cardiovascular Disease Physician
  • Woonsocket, RI
National Provider Identifier
1902227614
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PRIME HEALTHCARE SERVICES - LANDMARK ,LLC
Doing business as
Landmark EKG Dept
Practice address
115 Cass Ave
Woonsocket, RI 02895-4705
Phone
(401) 769-4100
Fax
(401) 765-6024
NPI assigned
Dec 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Richard Charest
Title
President
Phone
(401) 769-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

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 identifiers 1

IdentifierTypeStateIssuer
9006486MedicaidRI

Other names 1

  • Landmark EKG Dept Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services - Landmark LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1902227614",
    "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": "401-765-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - LANDMARK ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "CHAREST",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-769-4100"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006486",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Landmark EKG Dept",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 4, 2014; 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.