Healthcare Provider Details

I. General information

NPI: 1144605932
Provider Name (Legal Business Name): ORTHOPEDICS RHODE ISLAND, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 PROMENADE ST
PROVIDENCE RI
02908-5794
US

IV. Provider business mailing address

285 PROMENADE ST
PROVIDENCE RI
02908-5794
US

V. Phone/Fax

Practice location:
  • Phone: 401-459-4001
  • Fax: 401-459-4006
Mailing address:
  • Phone: 401-777-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: KYLE ANDERSON
Title or Position: VICE PRESIDENT OF FINANCE & ASC
Credential:
Phone: 401-777-7000