Active NPI
Jennifer Audette, M.S.
- Physical Therapist
- Kingston, RI
National Provider Identifier
1962558023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- RI000728
- Practice address
- 25 W Independence Way
Kingston, RI 02881-1124 - Phone
- (401) 874-5625
- Fax
- (401) 874-5630
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | RI000728 | RI | Primary |
Addresses
Primary practice location
25 W Independence Way
Kingston, RI 02881-1124
Mailing address
25 W Independence Way
Kingston, RI 02881-1124
Phone (401) 874-5625
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64-00196 | Other | RI | UNITED HEALTH PROVIDER ID |
| 7554-9 | Other | RI | BLUE CROSS PROVIDER ID |
| 411530 | Other | RI | BLUE CHIP PROVIDER ID |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RI000728 | RI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962558023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 W INDEPENDENCE WAY",
"city": "KINGSTON",
"state": "RI",
"postal_code": "028811124",
"telephone_number": "401-874-5625",
"fax_number": "401-874-5630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 W INDEPENDENCE WAY",
"city": "KINGSTON",
"state": "RI",
"postal_code": "028811124",
"telephone_number": "401-874-5625",
"fax_number": "401-874-5630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUDETTE",
"first_name": "JENNIFER",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "RI",
"license": "RI000728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH PROVIDER ID",
"identifier": "64-00196",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER ID",
"identifier": "7554-9",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP PROVIDER ID",
"identifier": "411530",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.