Active NPI
Thomas J. Coghlin, MD
- Ophthalmology Physician
- South Kingstown, RI
National Provider Identifier
1972530194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 30866
- Practice address
- 55 Village Square Drive
Building 24
South Kingstown, RI 02879 - Phone
- (401) 272-2020
- Fax
- (401) 789-4113
- NPI assigned
- Jun 26, 2006
- Last updated
- Sep 18, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 30866 | MA | Primary |
Addresses
Primary practice location
55 Village Square Drive
Building 24
South Kingstown, RI 02879
Mailing address
150 East Manning Street
Providence, RI 02906
Phone (401) 272-2020
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1102 | Other | NEIGHBORHOOD HEALTH | |
| 000899 | Other | BLUE CHIP | |
| 050369447 | Other | VISION SERVICE PLAN | |
| 7243170001 | Other | CIGNA | |
| 180012016 | Other | RAILROAD MEDICARE | |
| 0550502 | Other | AETNA HMO | |
| 5007211 | Other | AETNA NONHMO | |
| 718112 | Other | TUFTS | |
| AA41514 | Other | HARVARD PILGRIM | |
| 324 | Other | RI | BLUE CROSS BLUE SHIELD |
| 0800100 | Other | RI | UNITED HEALTHCARE |
| R001038 | Other | TRICARE | |
| TC00223 | Medicaid | RI |
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 |
|---|---|---|---|
| 30866 | MA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South County Eye Physicians and Surgeons Inc | Ophthalmology | Past | Accepting new patients |
| South County Physicians and Surgeons Inc - Optical Shope | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Ophthalmology Physician
- North Kingstown, RI
- NPI 1457306151
-
- Eyewear Supplier
- North Kingstown, RI
- NPI 1649223744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379462400000",
"number": "1972530194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 EAST MANNING STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02906",
"telephone_number": "401-272-2020",
"fax_number": "401-421-5979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 VILLAGE SQUARE DRIVE",
"address_2": "BUILDING 24",
"city": "SOUTH KINGSTOWN",
"state": "RI",
"postal_code": "02879",
"telephone_number": "401-272-2020",
"fax_number": "401-789-4113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COGHLIN",
"first_name": "THOMAS",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2013-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MA",
"license": "30866",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "1102",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "000899",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICE PLAN",
"identifier": "050369447",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7243170001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180012016",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "0550502",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NONHMO",
"identifier": "5007211",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "718112",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "AA41514",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "324",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0800100",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "R001038",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TC00223",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Kingstown, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.