Healthcare Provider Details

I. General information

NPI: 1407231293
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

300 CROSSINGS BLVD
WARWICK RI
02886-2878
US

IV. Provider business mailing address

200 CROSSINGS BLVD STE 310
WARWICK RI
02886-2872
US

V. Phone/Fax

Practice location:
  • Phone: 401-777-7000
  • Fax:
Mailing address:
  • Phone: 401-777-7000
  • Fax: 401-782-6810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

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