=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366426801
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEPHROLOGY ASSOCIATES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2005
-----------------------------------------------------
Last Update Date | 03/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 318 WATERMAN AVE
-----------------------------------------------------
City | EAST PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02914-3525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-438-5950
-----------------------------------------------------
Fax | 401-435-2561
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 318 WATERMAN AVE
-----------------------------------------------------
City | EAST PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-438-5950
-----------------------------------------------------
Fax | 401-435-2561
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MICHAEL THURSBY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 401-438-5950
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------