DR. DAVID B ETTENSOHN (NPI# 1134186067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134186067 |
| Entity Type | Individual |
| Full Name | DR. DAVID B ETTENSOHN |
| Credential | MD |
| Practice Address |
73 Beechwood Avenue Pawtucket RI 02860 |
| Practice Telephone | 4017244040 |
| Practice Fax Number | 4017229575 |
| Mailing Telephone | 4017244040 |
| Mailing Fax Number | 4017229575 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2013-09-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
06164 | RI | Allopathic & Osteopathic Physicians |
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
6164 | RI | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
06164 | RI | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
6164 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | RI MEDICAL LICENSE # | 6164 | 01 |
| RI | 7000422 | 05 |
| Street Address |
73 BEECHWOOD AVENUE |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972096923 | Lmb Medical LLC | Internal Medicine | 127 School St, Pawtucket, RI 02860 | 2018-06-13 |
| 1215420435 | Tyla Jackson | Behavior Technician | 70 Wood St Apt 22, Pawtucket, RI 02860 | 2018-06-12 |
| 1376048637 | Michael A Iadevaia | Family Medicine | 111 Brewster St Fl 3, Pawtucket, RI 02860 | 2018-03-28 |
| 1730690488 | Anthony Edwin Ramicone | Physician Assistant | 407 East Ave Ste 120, Pawtucket, RI 02860 | 2017-10-21 |
| 1669991352 | Kathleen K. Kroessler, Md; Neurology & Acupuncture, Inc. PC | Clinic/Center | 407 East Ave; Suite 110, Pawtucket, RI 02860 | 2017-09-13 |
| 1841716230 | Ri Alternative Academy Management, LLC | Local Education Agency (LEA) | 249 Roosevelt Avenue, Pawtucket, RI 02860 | 2017-08-17 |
| 1396265724 | Hannah R Stoops | Family Medicine | 111 Brewster St Fcc A, Pawtucket, RI 02860 | 2017-06-27 |
| 1427578400 | Shaun Michael Flynn | Family Medicine | 111 Brewster St, Fcc A, Pawtucket, RI 02860 | 2017-06-21 |
| 1073051843 | Laura Jane Amaral | Counselor | 750 East Ave Unit 1e, Pawtucket, RI 02860 | 2017-02-01 |
| 1063862027 | Stephanie Shoppell | Counselor | 105 Bacon Street, Pawtucket, RI 02860 | 2016-06-20 |
| Find all providers in zip 02860 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861613200 | Hassan-ettensohn Medical Specialists, Ltd | Internal Medicine | 73 Beechwood Ave, Pawtucket, RI 02860-5409 | 2007-05-02 |
| 1679798292 | Eric Gartman | Internal Medicine | 111 Brewster Street, Pawtucket, RI 02860 | 2007-04-17 |
| 1831232636 | Khalid A Alhourani | Internal Medicine | 111 Brewster Street, Pawtucket, RI 02860-4400 | 2007-02-14 |
| 1538275854 | Taro Minami | Internal Medicine | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860-4499 | 2006-08-21 |
| 1184609422 | Patricia Maria Russo-magno | Internal Medicine | 111 Brewster St, Department of Emergency Medicine, Pawtucket, RI 02860-4400 | 2005-12-09 |
| 1528041324 | Patrick Weyer | Internal Medicine | 111 Brewster St, Department of Critical Care/ Pulmonary Medicine, Pawtucket, RI 02860-4400 | 2005-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881089670 | Navneet Singh | Internal Medicine | 2 Dudley St. Coop 1, Providence, RI 02905-3236 | 2015-03-30 |
| 1518989367 | Michael Stanchina | Internal Medicine | 1285 S County Trl, East Greenwich, RI 02818-1620 | 2006-07-24 |
| 1154393486 | John Anthony Cece | Internal Medicine | 1131 Warwick Ave, Warwick, RI 02888-3545 | 2006-02-02 |
| 1538155080 | Mohammad D Khamiees | Internal Medicine | 3353 Mendon Rd Ste 3, Cumberland, RI 02864 | 2005-09-21 |
| 1093246399 | Daniel Dustin | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2017-03-27 |
| 1922400100 | Southern Rhode Island Pulmonary and Critical Care, LLC | Internal Medicine | 100 Kenyon Ave, Wakefield, RI 02879-4216 | 2014-09-19 |
| 1164867875 | Intensivists At Woonsocket | Internal Medicine | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2013-05-08 |
| 1538402557 | James Simmons | Internal Medicine | 593 Eddy St, Apc Building, 7th Floor, Providence, RI 02903-4923 | 2013-03-27 |
| 1700179942 | Andrew Foderaro | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2011-05-20 |
| 1811296692 | United Hospitalist and Intensivist Group, Inc | Internal Medicine | 25 John A Cummings Way, Box 3, Woonsocket, RI 02895-3224 | 2011-03-20 |
| 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.