Baxter Behavioral Health LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · North Kingstown, RI
NPI 1972975845 · NPPES record last updated Jun 5, 2024
Key facts
- NPI
- 1972975845
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- NPP37892 (RI)
- Legal business name
- BAXTER BEHAVIORAL HEALTH LLC
- Practice address
- 1130 Ten Rod Rd Ste D101
North Kingstown, RI 02852-4161 - Phone
- (401) 267-4485
- Fax
- (401) 267-4534
- NPI assigned
- Oct 30, 2015
- Organization subpart
- No
Authorized official
- Name
- Ryan Patrick Baxter, PMHPN-BC
- Title
- Owner
- Phone
- (401) 267-4485
Practitioners 5
-
Ryan Patrick Baxter Sr., MSN, APRN, PMHNP-BC
-
Gabrielle Koussa, PMHNP-BC
-
Reagan Lynn McGee, PMHNP-BC
-
Nicole Marie Sanchez, PMHNP-BC
-
Monique E Tarulli, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210105000857 | RI | Part B Supplier - Clinic/Group Practice | 0446663801 |
Receives reassigned benefits from 5 practitioners Practice locations: North Kingstown, RI |
National Provider Directory
Locations
5835 Post Rd
Ste 217
East Greenwich, RI 02818
Phone (401) 267-4485
1130 Ten Rod Rd
Ste D102
North Kingstown, RI 02852
Phone (401) 267-4485
1130 Ten Rod Rd
Ste D101
North Kingstown, RI 02852
Phone (401) 267-4485
1130 Ten Rod Rd
Bldg D
North Kingstown, RI 02852
Phone (401) 267-4485
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | NPP37892 | RI | Yes |
Addresses
Primary practice location
1130 Ten Rod Rd Ste D101
North Kingstown, RI 02852-4161
Mailing address
PO Box 949
North Kingstown, RI 02852-0610
Phone (401) 267-4485
Other practice location 1
5835 Post Rd
Unit 217
East Greenwich, RI 02818-2174
Phone (401) 267-4485
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972975485 | Medicaid | RI |
Other providers in North Kingstown, RI
- Kenneth Charles Baris Jr.
- Naomi Barnum
- Mark Steven Barone
- Mark Barry
- Margaret R. Bartlett
- Kristen J Baxter
- Ryan Patrick Baxter Sr.
- Shawn Patrick Baxter
- Bayside Family Healthcare, Inc.
- Bayview Operator, LLC
All providers in North Kingstown, RI · Psychiatric/Mental Health Nurse Practitioner in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.