Healthcare Provider Details

I. General information

NPI: 1548046402
Provider Name (Legal Business Name): VMD PRIMARY PROVIDERS OF RHODE ISLAND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 07/08/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 NATE WHIPPLE HWY STE 101
CUMBERLAND RI
02864-1403
US

IV. Provider business mailing address

PO BOX 30034
BELFAST ME
04915-2052
US

V. Phone/Fax

Practice location:
  • Phone: 401-658-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT RODGERS
Title or Position: VP REV CYCLE MANAGEMENT
Credential:
Phone: 412-206-1110