RI WELLNESS MEDICAL CENTER LLC NPI 1659025831

NPI Information

  • NPI: 1659025831
  • Provider Name: RI WELLNESS MEDICAL CENTER LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 41D2258442
  • Address: 1635 MINERAL SPRING AVE STE 203
    NORTH PROVIDENCE, RI
    ZIP 02904
  • Phone: (401) 525-8202

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NPI Details

RI WELLNESS MEDICAL CENTER LLC is a family nurse practitioner in North Providence, RI. RI WELLNESS MEDICAL CENTER LLC NPI is 1659025831. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1635 MINERAL SPRING AVE STE 203
NORTH PROVIDENCE, RI
ZIP 02904-025
Phone: (401) 525-8202
Fax: (308) 888-6638

The provider's authorized official is Eucharia U Ibeh .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (401) 525-8202.

The CLIA number assigned to this NPI record is 41D2258442 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/7/2022 and was last updated on 10/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11194326991MEDICAIDRHODE ISLAND
21659025831MEDICAIDRHODE ISLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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