| Narragansett Indian Tribe | |
|
51 Old Mill Rd Charlestown RI 02813-3322 | |
| (401) 364-1268 | |
| (401) 364-1030 |
| Full Name | Narragansett Indian Tribe |
|---|---|
| Speciality | Clinic/Center |
| Location | 51 Old Mill Rd, Charlestown, Rhode Island |
| Authorized Official Name and Position | Autumn Leaf Spears (DIRECTOR) |
| Authorized Official Contact | 4013641268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Narragansett Indian Tribe 4533 S County Trl Charlestown RI 02813-3428 Ph: (401) 364-1268 | Narragansett Indian Tribe 51 Old Mill Rd Charlestown RI 02813-3322 Ph: (401) 364-1268 |
| NPI Number | 1760532451 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 06/22/2020 |
| Medicare PECOS PAC ID | 3072406297 |
|---|---|
| Medicare Enrollment ID | O20040203000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760532451 | NPI | - | NPPES |
| 4101809 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Laurie J Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194769539 PECOS PAC ID: 6002709268 Enrollment ID: I20040203000696 |
| Provider Name | Mary Lyster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790715654 PECOS PAC ID: 2365427101 Enrollment ID: I20040624000027 |
| Provider Name | Thomas K Warcup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760433817 PECOS PAC ID: 5799745055 Enrollment ID: I20041012001113 |
| Provider Name | Robert J Casci |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528010824 PECOS PAC ID: 9133263999 Enrollment ID: I20100217000074 |
| Provider Name | Karen E Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720296916 PECOS PAC ID: 8628248887 Enrollment ID: I20110825000026 |
| Provider Name | Craig W Gaspard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366641417 PECOS PAC ID: 2365530524 Enrollment ID: I20171109001261 |
| Provider Name | Patricia Sebastian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962551804 PECOS PAC ID: 3476771395 Enrollment ID: I20191024002485 |
| Provider Name | Jackie Marlene Woodside |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982310710 PECOS PAC ID: 9032640479 Enrollment ID: I20241009001825 |
Narragansett Indian Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4533 S County Trl, Charlestown, RI 02813 Phone: 401-364-1268 Fax: 401-364-6427 | |
Liberty Advanced Integrative Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3769 Old Post Rd Ste C, Charlestown, RI 02813 Phone: 401-854-7955 Fax: 877-501-2230 |