Healthcare Provider Details

I. General information

NPI: 1306365812
Provider Name (Legal Business Name): SILVER SPRING HEALTH CARE MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WOODRUFF AVE STE 1
NARRAGANSETT RI
02882-3467
US

IV. Provider business mailing address

PO BOX 229
WAKEFIELD RI
02880-0229
US

V. Phone/Fax

Practice location:
  • Phone: 401-789-8543
  • Fax: 401-782-8766
Mailing address:
  • Phone: 401-788-8757
  • Fax: 401-782-9867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID FRANCIS FOGERTY JR.
Title or Position: DIRECTOR, DECISION SUPPORT
Credential:
Phone: 401-788-1978