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 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
| 2 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 3 | 207ZP0105X | Pathology | Clinical Pathology/Laboratory Medicine | | | No |
| 4 | 2084N0400X | Psychiatry & Neurology | Neurology | | | No |
| 5 | 2086S0129X | Surgery | Vascular Surgery | | | No |
| 6 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 7 | 282N00000X | General Acute Care Hospital | | HOS00125 | 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 | 0000006181 | OTHER | RHODE ISLAND | KENT COUNTY PHYS PATH |
| 2 | 000000001935 | OTHER | RHODE ISLAND | KENT COUNTY MEMORIAL HOSP |
| 3 | 0000000021 | OTHER | RHODE ISLAND | KENT COUNTY MEMORIAL HOSP |
| 4 | 0000006111 | OTHER | RHODE ISLAND | KENT COUNTY PHYS EKG |
| 5 | 0000006112 | OTHER | RHODE ISLAND | KENT COUNTY PHYS PULM |
| 6 | 5000154 | OTHER | RHODE ISLAND | KENT COUNTY MEMORIAL HOSP |
| 7 | OP00009 | MEDICAID | RHODE ISLAND | |
| 8 | 4100009 | MEDICAID | RHODE ISLAND | |
| 9 | 5000152 | OTHER | RHODE ISLAND | KENT COUNTY MEMORIAL HOSP |
| 10 | 709006109 | OTHER | RHODE ISLAND | KENT COUNTY PHYS VASC |
| 11 | 900247 | OTHER | RHODE ISLAND | KENT COUNTY MEMORIAL HOSP |
| 12 | 0000006109 | OTHER | RHODE ISLAND | KENT COUNTY PHYS VASC |
| 13 | 0000006110 | OTHER | RHODE ISLAND | KENT COUNTY PHYS EEG |
| 14 | DD3248 | OTHER | | KENT COUNTY HOSPITAL |
