{
"Npi": {
"NPI": "1740075977",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EMPOWER COMMUNITY HEALTH SERVICES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "136 CHESTER AVE FL 4",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PROVIDENCE",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02907-1245",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-425-1000",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "136 CHESTER AVE FL 4",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PROVIDENCE",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02907-1245",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-425-1000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/09/2025",
"LastUpdateDate": "12/18/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CORTES",
"AuthorizedOfficialFirstName": "SUENELLY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CCHW, PBT, CMA",
"AuthorizedOfficialTelephoneNumber": "401-492-3547",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "172V00000X",
"TaxonomyName": "Community Health Worker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}