| Name: | NHCC MEDICAL ASSOCIATES, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 25 Jun 1993 (32 years ago) |
| Identification Number: | 000073023 |
| ZIP code: | 02840 |
| County: | Newport County |
| Principal Address: | 11 FRIENDSHIP STREET, NEWPORT, RI, 02840, USA |
| Purpose: | SUPPORT, ENCOURAGE AND COORDINATE DEVELOPMENT OF COMPREHENSIVE, INTEGRATED HEALTH CARE-RELATED SERVICES. |
| NAICS: | 622110 - General Medical and Surgical Hospitals |
| Fictitious names: |
Family Physicians of Newport (trading name, 1994-01-26 - ) Family Physicians of Tiverton and Little Compton (trading name, 1994-01-26 - ) Family Physicians of Bristol (trading name, 1994-01-26 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598762304 | 2005-07-07 | 2011-01-21 | 275 BROADWAY, NEWPORT, RI, 028402612, US | 275 BROADWAY, UNIT 2, NEWPORT, RI, 028402612, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-845-1472 |
| Fax | 4018464874 |
Authorized person
| Name | FRANK BYRNE |
| Role | CFO- DIRECTOR OF FINANCE |
| Phone | 4018451545 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PS00223 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RR0500X - Rheumatology Physician |
| Is Primary | No |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | No |
| Taxonomy Code | 2084N0600X - Clinical Neurophysiology Physician |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 2086S0105X - Surgery of the Hand (Surgery) Physician |
| Is Primary | No |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9002585 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| PAUL J. ADLER | Agent | 245 CHAPMAN STREET SUITE 200, PROVIDENCE, RI, 02905, USA |
| Name | Role | Address |
|---|---|---|
| JEFFREY T GAINES MD | PRESIDENT | 11 FRIENDSHIP STREET NEWPORT, RI 02840 USA |
| Name | Role | Address |
|---|---|---|
| G. DEAN ROYE M.D. | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Number | Name | File Date |
|---|---|---|
| 202449067510 | Annual Report | 2024-03-14 |
| 202334044060 | Annual Report | 2023-04-26 |
| 202213203870 | Annual Report | 2022-03-21 |
| 202199504680 | Annual Report | 2021-07-23 |
| 202043385290 | Annual Report | 2020-06-26 |
| 201914609000 | Annual Report | 2019-08-22 |
| 201988698180 | Statement of Change of Registered/Resident Agent | 2019-03-15 |
| 201876282600 | Annual Report | 2018-08-30 |
| 201859038840 | Annual Report | 2018-02-23 |
| 201857372270 | Revocation Notice For Failure to File An Annual Report | 2018-02-02 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
