Jackie Marlene Woodside, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN04100 Issued in RI

Practice address

14 Woodruff Ave Ste 1
Narragansett, RI 02882-3467

Phone

(401) 789-8543

Fax

(401) 782-8766

NPI assigned

Jan 25, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Narragansett Indian TribeGroup PAC ID 3072406297, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South County Hospital Inc Hospital, Wakefield, RI, CCN 410008

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Narragansett Indian Tribe

  dba Narragansett Indian Health Center

  • Federally Qualified Health Center (FQHC)
  • Charlestown, RI
  • NPI 1760532451
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South County Hospital Healthcare System

  • General Acute Care Hospital
  • Wakefield, RI
  • NPI 1952366106
  Care Compare affiliation

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1982310710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 229",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028800229",
            "telephone_number": "401-788-3929",
            "fax_number": "401-788-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WOODRUFF AVE STE 1",
            "city": "NARRAGANSETT",
            "state": "RI",
            "postal_code": "028823467",
            "telephone_number": "401-789-8543",
            "fax_number": "401-782-8766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "268 Post Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028916601",
            "country_code": "US",
            "telephone_number": "401-604-2530",
            "fax_number": "401-604-2560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3461 S County Trl Ste 301",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028181463",
            "country_code": "US",
            "telephone_number": "401-471-6760",
            "fax_number": "401-471-6765",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Centerville Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028864336",
            "country_code": "US",
            "telephone_number": "401-562-1020",
            "fax_number": "401-562-1056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 Old Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "RI",
            "postal_code": "028133322",
            "country_code": "US",
            "telephone_number": "401-364-1268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODSIDE",
        "first_name": "JACKIE",
        "middle_name": "MARLENE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN04100",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": "RN58926",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #19189)
• Erica West, PT
• Nancy Elizabeth Wilson, LCMT
• Calie A Wise
• Grayson Blandy Wood III, D.AC.
• Brooke Young, DPT

• Gerontology Nurse Practitioner in Narragansett, RI
• Providers in Narragansett, RI by specialty
• Gerontology Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.