BURRILLVILLE HEALTH CENTER (NPI# 1073554812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073554812 |
| Entity Type | Organization |
| Organization Name | BURRILLVILLE HEALTH CENTER |
| Other Organization Name | BAYBERRY COMMONS |
| Practice Address |
181 Davis Dr Pascoag RI 02859-3507 |
| Practice Telephone | 4015680600 |
| Practice Fax Number | 4015683080 |
| Mailing Telephone | 4015680600 |
| Mailing Fax Number | 4015683080 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2008-02-05 |
| Authorized Official Name | DEBRAH L PUTMAN (ADMINISTRATOR) |
| Authorized Official Telephone | 4015680600 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | LTC00651 | RI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 4105080 | 05 | |
| EVERCARE | 7101152 | 01 | |
| UNITED HEALTH PLAN | 7100105 | 01 | |
| BLUE CHIP | 401581 | 01 |
| Other Name | Type Code |
|---|---|
| Bayberry Commons | Doing Business As Name - Organization |
| Street Address |
181 DAVIS DR |
| City | PASCOAG |
| State | RI |
| Zip Code | 02859-3507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841712973 | Nancy Jean Quintiliani | Physical Therapist | 181 Davis Dr, Pascoag, RI 02859-3507 | 2017-07-11 |
| 1205105517 | Northwest Community Health Care | Clinic/Center | 181 Davis Dr, Pascoag, RI 02859-3507 | 2011-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811397763 | Patricia Scuncio | Physical Therapy Assistant | 252 Donahue Road, Pascoag, RI 02859 | 2014-08-28 |
| 1134479520 | Kimberly Mary Cote | Social Worker | 2078 Wallum Lake Rd., Pascoag, RI 02859 | 2012-09-13 |
| 1487923793 | Northwest Community Health Care | Clinic/Center | 999 S. Main Street, Pascoag, RI 02859 | 2011-12-16 |
| 1730343666 | James Edward Sullivan | Counselor | 2076 Wallum Lake Rd, Pascoag, RI 02859 | 2008-07-10 |
| 1427243682 | Julie A. Vander Schel | Counselor | 2076 Wallum Lake Road, Pascoag, RI 02859 | 2007-09-11 |
| 1699985226 | Donna Watson | Counselor | 2198 Wallum Lake Rd., Pascoag, RI 02859 | 2007-05-23 |
| 1194817197 | Purvi Chokshi | Internal Medicine | 2090 Wallum Lake Road, Pascoag, RI 02859 | 2006-09-28 |
| 1659395622 | Dennis Edward Joyce | Counselor | 2198 Wallum Lake Road, Pascoag, RI 02859 | 2006-07-26 |
| 1427087782 | Robert James Brothers | Counselor | 2198 Wallum Lake Rd, Pascoag, RI 02859 | 2006-06-30 |
| 1245219070 | Northwest Community Health Care | Clinic/Center | 36 Bridge Way, Pascoag, RI 02859 | 2006-01-11 |
| Find all providers in zip 02859 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235676289 | Modupe | Nursing Facility/Intermediate Care Facility | 1 Kristen Dr, North Providence, RI 02911-2932 | 2017-01-30 |
| 1881840932 | South Bay Manor | Nursing Facility/Intermediate Care Facility | 1959 Kingstown Road, South Bay Retirement Living, South Kingstown, RI 02879-1608 | 2008-08-08 |
| 1396916748 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 3 Old Clark Rd, Smithfield, RI 02917-4103 | 2008-03-13 |
| 1740490481 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 30 Ida Ln, Woonsocket, RI 02895-6245 | 2007-05-23 |
| 1518177245 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 99 Elm St, Woonsocket, RI 02895-2187 | 2007-05-23 |
| 1386854024 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 569 Park Ave, Woonsocket, RI 02895-5833 | 2007-05-23 |
| 1366652000 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 81 Willis Dr, Cumberland, RI 02864-2033 | 2007-05-23 |
| 1659581395 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 362 Lydia Ave, Woonsocket, RI 02895-6619 | 2007-05-23 |
| 1568672202 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 626 Mendon Rd, North Smithfield, RI 02896-6962 | 2007-05-23 |
| 1477763118 | The Homestead Group | Nursing Facility/Intermediate Care Facility | 106 Minerva St, Woonsocket, RI 02895-6356 | 2007-05-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.