Organization Active NPI

University Concierge Medicine LLC

Doing business as Newport Personalized Medicine

  • Internal Medicine Physician
  • Middletown, RI
National Provider Identifier
1992239081
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7724 Issued in RI
Legal business name
UNIVERSITY CONCIERGE MEDICINE LLC
Doing business as
Newport Personalized Medicine
Practice address
1 Corporate PL
Middletown, RI 02842-6406
Phone
(401) 619-4884
Fax
(401) 619-4886
NPI assigned
Apr 14, 2017
Last updated
Jun 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Authorized official

Name
Dr. David Francis Cunningham, M.D.NPI 1720073406
Title
Owner
Phone
(401) 619-4884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7724 RI Primary

Addresses

Primary practice location

1 Corporate PL
Middletown, RI 02842-6406

Mailing address

1 Corporate PL
Middletown, RI 02842-6406
Phone (401) 619-4884

Other names 1

  • Newport Personalized Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170601000876 RI Part B Supplier - Clinic/Group Practice 2365719085 Receives reassigned benefits from 1 practitioner
Practice locations: Middletown, RI

National Provider Directory

National Provider Directory

Locations

1 Corporate Pl
Middletown, RI 02842
Phone (401) 619-4884

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498089600000",
    "number": "1992239081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CORPORATE PL",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028426406",
            "telephone_number": "401-619-4884",
            "fax_number": "401-619-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CORPORATE PL",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028426406",
            "telephone_number": "401-619-4884",
            "fax_number": "401-619-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY CONCIERGE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-14",
        "last_updated": "2017-06-22",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-619-4884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "7724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Personalized Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.