Clyde E Ross

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

2218047 Issued in RI

Practice address

225 Main Street
Pawtucket, RI 02860-0000

Phone

(401) 475-0636

Fax

(401) 205-1026

NPI assigned

Aug 7, 2025

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Community Health Services LLC

  • Community Health Worker
  • Pawtucket, RI
  • NPI 1780556746
  NPD Authorized official

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1992680276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MAIN STREET",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028600000",
            "telephone_number": "401-475-0636",
            "fax_number": "401-205-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MAIN STREET",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028600000",
            "telephone_number": "401-475-0636",
            "fax_number": "401-205-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CLYDE",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "RI",
            "license": "2218047",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul G. Roque, D.D.S.
• Andrew Rork, DO
• Nathali Rosa, LCSW
• Madeline Rosario-Almonte, CCM
• Marta Rosol, LICSW
• Craig Frederick Ross, MS, CCC-SLP
• Monica Ross
• Margaret Rossano, MD
• Mark Rubinstein
• Paul John Rubolotta, OCCUPATIONAL THERAPI

• Community Health Worker in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Community Health Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.