THUNDERMIST HEALTH CENTER NPI 1700041001

NPI Information

NPI: 1700041001
Provider Name: THUNDERMIST HEALTH CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 41D2099634

Address:
1 RIVER ST
WAKEFIELD, RI
ZIP 02879
Phone: (401) 783-0523
Get Directions

THUNDERMIST HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Wakefield, RI. THUNDERMIST HEALTH CENTER NPI is 1700041001. The provider is registered as an organization entity type.

The provider's business location address is:

1 RIVER ST
WAKEFIELD, RI
ZIP 02879-214
Phone: (401) 783-0523
Fax: (401) 783-9448

The provider's authorized official is Ckarla Agudelo .
The authorized official title is Credentialing Specialist and has the following contact phone number (401) 767-4100.

The CLIA number assigned to this NPI record is 41D2099634 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/25/2008 and was last updated on 6/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251S00000X	Community/Behavioral Health		ACF01566	RHODE ISLAND	No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	ACF01566	RHODE ISLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4101805	MEDICAID	RHODE ISLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »