MICHAEL C COBURN (NPI# 1720040728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720040728 |
| Entity Type | Individual |
| Full Name | MICHAEL C COBURN |
| Credential | MD |
| Practice Address |
1950 Tower Hill Rd North Kingstown RI 02852-6639 |
| Practice Telephone | 4015593954 |
| Practice Fax Number | 4012944116 |
| Mailing Telephone | 4015593954 |
| Mailing Fax Number | 4012944116 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
MD08308 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | BCBSRI | 838-7 | 01 |
| RI | 7004684 | 05 | |
| RI | BCBSRI/CHIP | 005185 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 875 Centerville Rd, Suite 15, Warwick, RI 028864381 | 4016158500 | 4016158503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396955456 | Michael Allen Coburn | Physical Medicine & Rehabilitation | 14507 Hawthorne Blvd, Lawndale, CA 90260-1520 | 2007-05-23 |
| 1629636022 | Michael Coburn | Behavior Technician | 9900 Gilmore Ridge Rd, Nashville, IN 47448-9731 | 2019-05-31 |
| 1457820037 | Michael Coburn | Nurse Practitioner | 3662 W Ina Rd Ste 150, Tucson, AZ 85741-2269 | 2018-11-13 |
| 1881784536 | Michael Coburn | Internal Medicine | 6620 Main St, Suite 1325, Houston, TX 77030-2348 | 2006-10-13 |
| Street Address |
1950 TOWER HILL RD |
| City | NORTH KINGSTOWN |
| State | RI |
| Zip Code | 02852-6639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124586508 | Lindsey Crowninshield | Counselor | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2019-03-05 |
| 1588179287 | Danielle Cunningham | Counselor | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2017-12-05 |
| 1376072348 | Katherine Kerr Anderson | Social Worker | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2017-06-05 |
| 1376999193 | Katelynn Sorrentino | Counselor | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2016-05-11 |
| 1265825053 | Justine Stroble | Registered Nurse | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2015-03-18 |
| 1700277373 | Kayla E Kiers | Licensed Vocational Nurse | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2015-02-18 |
| 1144619172 | Marlena-ray Breault | Counselor | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2015-01-14 |
| 1902201148 | Ashley Thrasher | Registered Nurse | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2014-10-30 |
| 1699175836 | Heather Butler | Registered Nurse | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2014-08-25 |
| 1164822474 | Adcare Rhode Island | Substance Abuse Rehabilitation Facility | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2014-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063037059 | Rhode Island Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4255 Quaker Lane, North Kingstown, RI 02852 | 2020-06-15 |
| 1588216543 | Stop Look & Listen LLC | Counselor | 917 Ten Rod Rd, 917 Ten Rod Rd., North Kingstown, RI 02852 | 2019-07-10 |
| 1841856358 | Carlos Albert Saraiva | Pharmacist | 113 Frenchtown Road, North Kingstown, RI 02852 | 2019-05-10 |
| 1184143851 | Jessica Topitzer | Nurse Practitioner | 426f Scrabbletown Rd., N. Kingstown, RI 02852 | 2017-09-14 |
| 1275074940 | Amanda Kathryn Lennon | Social Worker | 2 Ripple Lane, North Kingstown, RI 02852 | 2017-03-15 |
| 1164975728 | Charlotte Elizabeth Bigg | Dentist | 145 Phillips St, North Kingstown, RI 02852 | 2016-08-01 |
| 1043603913 | Pamela Morelli | Social Worker | 426 Scrabbletown Rd., North Kingstown, RI 02852 | 2015-03-16 |
| 1942691845 | Catherine Cooney | Counselor | 1130 Ten Rod Rd, Ste E305, North Kingstown, RI 02852 | 2015-02-12 |
| 1154753168 | Kenneth N Beaupre | Counselor | 23 Brown St Ste 107, North Kingstown, RI 02852 | 2013-07-31 |
| 1154613909 | Kimberly Micucci | Counselor | 1950 Tower Hill Road, Acute Stabilization Unit, North Kingstown, RI 02852 | 2011-05-12 |
| Find all providers in zip 02852 | ||||
| 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 |
|---|---|---|---|---|
| 1205259793 | Kevin E Baill, Md and Associates, LLC | Psychiatry & Neurology | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2014-02-04 |
| 1194943845 | Lincoln Psychiatric Services, Inc. | Psychiatry & Neurology | 652 George Washington Hwy, Suite 400, Lincoln, RI 02865-4267 | 2007-04-20 |
| 1649281007 | Robert Michael Swift | Psychiatry & Neurology | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2006-08-11 |
| 1518973148 | Walter Dulany Fitzhugh IIi | Psychiatry & Neurology | 8 Blackstone Valley Pl, Lincoln, RI 02865-1145 | 2006-08-01 |
| City | NORTH KINGSTOWN |
| Zip Code | 02852 |
Please comment or provide details below to improve the information on MICHAEL C COBURN.
| 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.