Individual provider Active NPI

Judith Dubois, RN, LCDP

  • Registered Nurse
  • Providence, RI
National Provider Identifier
1902846322
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN31644 Issued in RI
Practice address
530 N Main St
Providence, RI 02904-5762
Phone
(401) 274-2500
NPI assigned
Jun 7, 2006
Last updated
May 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDP00658 RI
Registered Nurse 163W00000X RN31644 RI Primary

Addresses

Primary practice location

530 N Main St
Providence, RI 02904-5762

Mailing address

528 N Main St
Providence, RI 02904-5757

Other identifiers 3

IdentifierTypeStateIssuer
1902846322OtherRIUBH
JM54958MedicaidRI
1104847946OtherRITHE PROVIDENCE CENTER NPI

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
CDP00658RIMDAddiction (Substance Use Disorder) Counselor
RN31644RIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: judubois@direct.carene.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1902846322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "401-274-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "JUDITH",
        "credential": "RN, LCDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDP00658",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN31644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "1902846322",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JM54958",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE PROVIDENCE CENTER NPI",
            "identifier": "1104847946",
            "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 May 4, 2021; 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.