KEVIN E BAILL, MD AND ASSOCIATES, LLC (NPI# 1205259793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205259793 |
| Entity Type | Organization |
| Organization Name | KEVIN E BAILL, MD AND ASSOCIATES, LLC |
| Other Organization Name | EAST SIDE RECOVERY SERVICES |
| Practice Address |
345 Blackstone Blvd Providence RI 02906-4800 |
| Mailing Address |
Po Box 603198 Providence RI 02906-0198 |
| Practice Telephone | 9174472138 |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-03-13 |
| Authorized Official Name | DR. KEVIN ELLIOT BAILL (PRESIDENT) |
| Authorized Official Telephone | 9174472138 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
12179 | RI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| East Side Recovery Services | Doing Business As Name - Organization |
| Street Address |
345 BLACKSTONE BLVD |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203690 | Andrew Seth Rosenzweig | Psychiatry & Neurology | 345 Blackstone Blvd, Rm. 232 2nd Floor Annex Building, Providence, RI 02906-4800 | 2005-05-24 |
| 1356940860 | Diane Medeiros Gomes | Pharmacist | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-10-26 |
| 1013528199 | Michael Gunson | Physician Assistant | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-08-12 |
| 1902423775 | Elyssa Sham | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-28 |
| 1407472400 | Amy Rebecca Johnson | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-25 |
| 1669096772 | Olivia Hunt | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-04 |
| 1922622125 | Carla Julia Hasson | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906 | 2020-06-03 |
| 1023632395 | Micah Benjamin Duggins-warf | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-03 |
| 1982228060 | Armond Collins | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-06-03 |
| 1508485301 | Brian Charles Castelluccio | Clinical Neuropsychologist | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2020-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649281007 | Robert Michael Swift | Psychiatry & Neurology | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720040728 | Michael C Coburn | Psychiatry & Neurology | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2006-04-05 |
| 1194943845 | Lincoln Psychiatric Services, Inc. | Psychiatry & Neurology | 652 George Washington Hwy, Suite 400, Lincoln, RI 02865-4267 | 2007-04-20 |
| 1518973148 | Walter Dulany Fitzhugh IIi | Psychiatry & Neurology | 8 Blackstone Valley Pl, Lincoln, RI 02865-1145 | 2006-08-01 |
| City | PROVIDENCE |
| Zip Code | 02906 |
Please comment or provide details below to improve the information on KEVIN E BAILL, MD AND ASSOCIATES, LLC.
| 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.