Wellone Primary Medical And Dental Care | |
308 Callahan Rd N. Kingstown RI 02852-7739 | |
(401) 295-9706 | |
(401) 295-0920 |
Full Name | Wellone Primary Medical And Dental Care |
---|---|
Speciality | Clinic/Center |
Location | 308 Callahan Rd, N. Kingstown, Rhode Island |
Authorized Official Name and Position | Peter J. Bancroft (PRESIDENT & CEO) |
Authorized Official Contact | 4012855119 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wellone Primary Medical And Dental Care Po Box 312 Pascoag RI 02859 Ph: (401) 568-7664 | Wellone Primary Medical And Dental Care 308 Callahan Rd N. Kingstown RI 02852-7739 Ph: (401) 295-9706 |
NPI Number | 1801951397 |
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Provider Enumeration Date | 12/26/2006 |
Last Update Date | 10/21/2011 |
Medicare PECOS PAC ID | 1355250663 |
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Medicare Enrollment ID | O20050308000422 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801951397 | NPI | - | NPPES |
NC50602 | Medicaid | RI | |
BS41305 | Medicaid | RI | |
BS41307 | Medicaid | RI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | ACF01530 (Rhode Island) | Secondary |
261QC1500X | Clinic/center - Community Health | ACF01597 (Rhode Island) | Primary |
Provider Name | Joan K Mullaney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588611503 PECOS PAC ID: 6305820713 Enrollment ID: I20040615000199 |
Provider Name | Linda Eibel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386657096 PECOS PAC ID: 9830167741 Enrollment ID: I20040920000206 |
Provider Name | Clifford I Gordon |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1942306675 PECOS PAC ID: 8729039987 Enrollment ID: I20050204000110 |
Provider Name | Mary L Giovetti |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720180367 PECOS PAC ID: 8224082680 Enrollment ID: I20050309000003 |
Provider Name | Steven Diehl |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1215988175 PECOS PAC ID: 7214985779 Enrollment ID: I20051201000461 |
Provider Name | Joanna Brown |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720059025 PECOS PAC ID: 0345322418 Enrollment ID: I20080128000783 |
Provider Name | Barry J Giordano |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1346386646 PECOS PAC ID: 2961442793 Enrollment ID: I20111014000324 |
Provider Name | Leonard Anthony Mannarelli |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1982770764 PECOS PAC ID: 3274693536 Enrollment ID: I20120227000719 |
Provider Name | Desirae Heys |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316381205 PECOS PAC ID: 7810137940 Enrollment ID: I20130712000179 |
Provider Name | Dayna Orourke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053488379 PECOS PAC ID: 7618105743 Enrollment ID: I20140116000657 |
Provider Name | Elizabeth A Sherman |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1730595893 PECOS PAC ID: 5092933937 Enrollment ID: I20140905001673 |
Provider Name | Stephanie Pinto |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235548371 PECOS PAC ID: 8820210743 Enrollment ID: I20141110001046 |
Provider Name | Jennifer Ugbanaja |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1043646128 PECOS PAC ID: 2062738560 Enrollment ID: I20150227000687 |
Provider Name | Nicole Coggins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356723548 PECOS PAC ID: 5193031938 Enrollment ID: I20150825003628 |
Provider Name | Saima Kane |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841686052 PECOS PAC ID: 3971812975 Enrollment ID: I20151014000071 |
Provider Name | Nicole D. Burns |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235597139 PECOS PAC ID: 4385942259 Enrollment ID: I20160408000651 |
Provider Name | Erica L Magaziner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497130744 PECOS PAC ID: 7113235409 Enrollment ID: I20170512000111 |
Provider Name | Steven Joel Hershey |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1831120260 PECOS PAC ID: 0143506345 Enrollment ID: I20170615001118 |
Provider Name | Ryan Heney |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528447182 PECOS PAC ID: 8527371087 Enrollment ID: I20181002002214 |
Provider Name | Charles D Fraser |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184101610 PECOS PAC ID: 5890048219 Enrollment ID: I20181031001994 |
Provider Name | Michala Jorrin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255784005 PECOS PAC ID: 3375812076 Enrollment ID: I20181119001917 |
Provider Name | Missy Buco |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306318290 PECOS PAC ID: 5799022893 Enrollment ID: I20190128002945 |
Provider Name | Alice Mui |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275032476 PECOS PAC ID: 8729312376 Enrollment ID: I20190702000266 |
Provider Name | Stephanie Forget |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346623691 PECOS PAC ID: 8325349087 Enrollment ID: I20201120002370 |
Provider Name | Michelle L Fox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003243148 PECOS PAC ID: 7315160504 Enrollment ID: I20210810003084 |
Provider Name | Amanda Marie Gould |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437633435 PECOS PAC ID: 8224427596 Enrollment ID: I20211109000469 |
Provider Name | John Paul Carvalho |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1033375829 PECOS PAC ID: 9436549896 Enrollment ID: I20211130000636 |
Provider Name | Tina Marie Parker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386237154 PECOS PAC ID: 2769860147 Enrollment ID: I20220526001796 |
Provider Name | Yolanda Dasilva-melo |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1255864443 PECOS PAC ID: 6507240561 Enrollment ID: I20220825001630 |
Provider Name | Garrett S Bowen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619505385 PECOS PAC ID: 8123442126 Enrollment ID: I20230920001388 |
Provider Name | Marie Amelia Capobianco |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1306285143 PECOS PAC ID: 0941652887 Enrollment ID: I20240117000375 |
Provider Name | Maureen Day O'shea |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1477856490 PECOS PAC ID: 2668824368 Enrollment ID: I20240118001349 |
Provider Name | Melissa Sabatini |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1740727650 PECOS PAC ID: 7517319767 Enrollment ID: I20240123004349 |
Provider Name | Amy E Sweet |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1629201967 PECOS PAC ID: 6800249624 Enrollment ID: I20240129002378 |