ADAM TAKEO ELLENTHAL (NPI# 1447884861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447884861 |
| Entity Type | Individual |
| Full Name | ADAM TAKEO ELLENTHAL |
| Practice Address |
21 Peace St Providence RI 02907-1510 |
| Mailing Address |
10 Amsterdam Ave Apt 305 New York NY 10023-7489 |
| Practice Telephone | 4014564461 |
| Mailing Telephone | 9548502669 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
21 PEACE ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02907-1510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033103098 | Stanley John Stutz Jr. | Orthopaedic Surgery | 21 Peace St, Corporate Care, Providence, RI 02907-1510 | 2005-09-07 |
| 1083249098 | Anna Lam | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2020-03-10 |
| 1275166050 | Christopher Padhi | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2020-02-19 |
| 1770040412 | Tyler Anthony Beninati | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-03-01 |
| 1972060606 | Gabrielle Morgan Lieberman | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-02-28 |
| 1962969691 | John Anthony Power IIi | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-02-28 |
| 1386101541 | Victoria Anne Gill | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-02-25 |
| 1740772037 | Tiffany Diem Tu Ngo | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2018-06-01 |
| 1841794500 | Amrita Khemka | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2018-03-19 |
| 1740793694 | Ivette Sena | Registered Nurse | 21 Peace St, Providence, RI 02907-1510 | 2017-11-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518522861 | Catherine M Katzberg | Massage Therapist | Santosha Yoga Studio, 275 Reservoir Ave, Providence, RI 02907 | 2019-05-02 |
| 1104317007 | Victa LLC | Internal Medicine | 110 Elmwood Ave # A, Providence, RI 02907 | 2018-05-25 |
| 1639566987 | Southside Elementary Charter School | Local Education Agency (LEA) | 126 Somerset Street, Providence, RI 02907 | 2015-04-23 |
| 1063846558 | Achievement First Providence Mayoral Academy Charter School | Local Education Agency (LEA) | 370 Hartford Aveneue, Providence, RI 02907 | 2013-09-03 |
| 1912297425 | Reynaldo P Baduya Sr.,dmd | Clinic/Center | 252 Adelaide Avenue, Providence, RI 02907 | 2011-04-18 |
| 1821218587 | Map Behavioral Health Serv. Inc. | Community/Behavioral Health | 66 Burnett Street, Providence, RI 02907 | 2007-04-26 |
| 1548336944 | Angelica Redleaf | Chiropractor | 1196 Elmwood Avenue, Providence, RI 02907 | 2006-11-28 |
| 1174619878 | Emilio Rodriguez-peris | Internal Medicine | 655 Broad Street, Suite 201, Providence, RI 02907 | 2006-10-04 |
| 1841381555 | Maged Taman | Internal Medicine | 21 Peace Street, Providence, RI 02907 | 2006-09-27 |
| 1003924226 | Gladys V Rezendes | Psychologist | 118 Comstock Avenue, Providence, RI 02907 | 2006-08-28 |
| Find all providers in zip 02907 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475755 | Sarah Fellows | Student in an Organized Health Care Education/Training Program | 350 Eddy Street, Uri Nursing Education Center, Providence, RI 02903 | 2020-10-20 |
| 1346856382 | Carly Danielle Masse | Student in an Organized Health Care Education/Training Program | 350 Eddy St, Providence, RI 02903-4202 | 2020-09-16 |
| 1194337220 | Shannon Adams | Student in an Organized Health Care Education/Training Program | Brown University Box G-9999, Providence, RI 02912-0001 | 2020-08-19 |
| 1023647534 | Mary Reedy | Student in an Organized Health Care Education/Training Program | 17 University Ave, Providence, RI 02906-4121 | 2020-04-06 |
| 1730747502 | Kristian Georgiev | Student in an Organized Health Care Education/Training Program | Brown University Box G-9525, Providence, RI 02912-0001 | 2019-06-05 |
| 1053975896 | Chad Simon | Student in an Organized Health Care Education/Training Program | 70 Kennedy Plz Unit 2, Providence, RI 02903-2000 | 2019-04-26 |
| 1437642709 | Adrian Cotarelo | Student in an Organized Health Care Education/Training Program | 174 Wickenden St, Apt. 3rd Floor, Providence, RI 02903 | 2018-06-12 |
| 1134616055 | Muyide Olujola Satiregun | Student in an Organized Health Care Education/Training Program | 252 Dudley St, Providence, RI 02907-1011 | 2018-04-16 |
| 1659887503 | Michele Tracy Diamond | Student in an Organized Health Care Education/Training Program | 830 Chalkstone Ave Bldg 2, Providence, RI 02908-4734 | 2017-12-14 |
| 1851821268 | Jia Jennifer Ding | Student in an Organized Health Care Education/Training Program | 101 Dudley St Ste 1440, Providence, RI 02905-2401 | 2017-06-18 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02907 |
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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.