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 | 335E00000X | Prosthetic/Orthotic Supplier | | | 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 | 0082-0000017 | OTHER | RHODE ISLAND | UNITEDHEALTHCARE |
| 2 | 402559 | OTHER | RHODE ISLAND | BLUE CHIP OF RHODE ISLAND |
| 3 | 89M057592RI01 | OTHER | CONNECTICUT | ANTHEM BLUE CROSS |
| 4 | 900-9676 | MEDICAID | RHODE ISLAND | |
| 5 | 0000009676 | OTHER | RHODE ISLAND | BLUE CROSS/BLUE SHIELD FEDERAL EMPLOYEE PROGRAM |
| 6 | 0007849607 | OTHER | RHODE ISLAND | AETNA |
| 7 | 1598724007 | OTHER | RHODE ISLAND | WPS TRICARE |
| 8 | 0575920001 | MEDICARE NSC | RHODE ISLAND | |
| 9 | 1598724007 | OTHER | RHODE ISLAND | UNICARE |
| 10 | =========-001 | OTHER | MASSACHUSETTS | CONSOLIDATED HEALTH |
| 11 | 9676-8 | OTHER | RHODE ISLAND | BC/BS OF RHODE ISLAND |
| 12 | ========= | OTHER | RHODE ISLAND | AETNA INSURANCE |
