Active NPI
Charles E McCoy, MD
- Nephrology Physician
- East Providence, RI
National Provider Identifier
1922081447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 7312
- Practice address
- 318 Waterman Ave
East Providence, RI 02914 - Phone
- (401) 438-5950
- Fax
- (401) 435-2561
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 7312 | RI | Primary |
| Nephrology Physician | 207RN0300X | 54730 | MA |
Addresses
Primary practice location
318 Waterman Ave
East Providence, RI 02914
Mailing address
318 Waterman Ave
East Providence, RI 02914
Phone (401) 438-5950
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201149 | Other | RI | BLUE CHIP |
| 110047054B | Medicaid | MA | |
| 1487 | Other | NEIGHBORHOOD | |
| 7000736 | Medicaid | RI | |
| 00000003716 | Other | MA | BOSTON MEDICAL |
| 1220212002 | Other | CIGNA | |
| 3085902 | Other | MA WELFARE | |
| J08648 | Other | MA | BLUE CROSS |
| 054730 | Other | TUFTS | |
| 3100113 | Other | UNITED | |
| 10015RIH | Other | HARVARD PILGRIM | |
| 390001779 | Other | RAILROAD MEDICARE | |
| 7312 | Other | RI | BLUE CROSS |
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 |
|---|---|---|---|
| 7312 | RI | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256774400000",
"number": "1922081447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 WATERMAN AVE",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "02914",
"telephone_number": "401-438-5950",
"fax_number": "401-435-2561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 WATERMAN AVE",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "02914",
"telephone_number": "401-438-5950",
"fax_number": "401-435-2561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "CHARLES",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2009-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "RI",
"license": "7312",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MA",
"license": "54730",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "201149",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110047054B",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD",
"identifier": "1487",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7000736",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOSTON MEDICAL",
"identifier": "00000003716",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1220212002",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA WELFARE",
"identifier": "3085902",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J08648",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "054730",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED",
"identifier": "3100113",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "10015RIH",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "390001779",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "7312",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.