| Name: | South County Primary Care, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 24 Aug 2000 (25 years ago) |
| Identification Number: | 000114109 |
| ZIP code: | 02882 |
| County: | Washington County |
| Principal Address: | 360 KINGSTOWN ROAD STE 104, NARRAGANSETT, RI, 02882, USA |
| Purpose: | TO ENGAGE IN THE PRACTICE OF MEDICINE |
| Fictitious names: |
South County Walk-In and Primary Care, Inc. (trading name, 2000-10-02 - ) |
| Historical names: |
Hanson and Gross, Inc. |
NAICS
621111 Offices of Physicians (except Mental Health Specialists)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306816251 | 2006-01-24 | 2018-06-20 | 360 KINGSTOWN RD, SUITE 104, NARRAGANSETT, RI, 028823239, US | 360 KINGSTOWN RD, SUITE 104, NARRAGANSETT, RI, 028823239, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-789-1086 |
| Fax | 4017895344 |
Authorized person
| Name | DR. MONICA LOUISE GROSS |
| Role | OWNER |
| Phone | 4017891086 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | MD09154 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUECHIP |
| Number | 407659 |
| State | RI |
| Issuer | MEDICAID |
| Number | 9000328 |
| State | RI |
| Issuer | NHPRI |
| Number | 1962 |
| State | RI |
| Issuer | BCBS |
| Number | 22374-2 |
| Issuer | UNITED HEALTH PLAN |
| Number | 44-00013 |
| Issuer | NHP |
| Number | 2464 |
| State | RI |
| Issuer | HEALTH PARTNERS |
| Number | 111745 |
| Name | Role | Address |
|---|---|---|
| STEPHEN D. ZUBIAGO, ESQ. | Agent | NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| MONICA L GROSS M.D. | PRESIDENT | 360 KINGSTOWN ROAD, SUITE 104 NARRAGANSETT, RI 02882 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2000-10-02 | Hanson and Gross, Inc. | South County Primary Care, Inc. |
| Number | Name | File Date |
|---|---|---|
| 202449404270 | Annual Report | 2024-03-22 |
| 202335497180 | Annual Report | 2023-05-10 |
| 202216808270 | Annual Report | 2022-04-25 |
| 202194662790 | Annual Report | 2021-03-17 |
| 202035670810 | Annual Report | 2020-02-28 |
| 201989678190 | Annual Report | 2019-04-01 |
| 201859869480 | Annual Report | 2018-03-07 |
| 201738398690 | Annual Report | 2017-03-22 |
| 201692589880 | Annual Report | 2016-02-16 |
| 201558222900 | Annual Report | 2015-03-30 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3749467804 | 2020-05-27 | 0165 | PPP | 360 Kingstown Road 104, Narragansett, RI, 02882 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
