Carlos H Nieto, MD

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

04725 Issued in RI

Practice address

300 Tollgate Rd
Suite 301a
Warwick, RI 02886

Phone

(401) 739-4844

Fax

(401) 739-4415

NPI assigned

Jun 19, 2006

Reactivated

Nov 25, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1982649398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOLLGATE RD",
            "address_2": "SUITE 301A",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-739-4844",
            "fax_number": "401-739-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOLLGATE RD",
            "address_2": "SUITE 301A",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-739-4844",
            "fax_number": "401-739-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "CARLOS",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2008-11-25",
        "deactivation_date": "2008-11-10",
        "reactivation_date": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "RI",
            "license": "04725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS",
            "identifier": "2279-4",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanny Nhem-Raphael, RN, CDOE
• Guy R Nicastri, MD
• Alexia Nicholas, MHC-A
• Katty A Nichols, RN
• Patricia Agnes Nichols
• Lily Nieto
• Beatrijs Nightingale, LCDP
• Nikkora, LLC
• Nicholas T Nikolopoulos, DO
• Isabelle Victoria Nilerud, PA-C

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.