| Name: | Coastal Medical Physicians, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 07 Feb 2020 (5 years ago) |
| Identification Number: | 001704570 |
| ZIP code: | 02903 |
| County: | Providence County |
| Principal Address: | 10 DAVOL SQUARE, PROVIDENCE, RI, 02903, USA |
| Purpose: | THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (THE CODE). THE CORPORATION IS FURTHER ORGANIZED TO PROVIDE ACCOUNTABLE PATIENT-CENTERED, HIGH QUALITY, EFFICIENT, VALUE BASED AND INNOVATIVE CARE TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITIES IN RHODE ISLAND AND ELSEWHERE, INCLUDING THOSE SERVED BY THE HOSPITALS AFFILIATED WITH LIFESPAN CORPORATION (LIFESPAN), AND TO PROMOTE AND ADVANCE MEDICAL RESEARCH, EDUCATION AND TRAINING IN MEDICINE, MEDICAL RELATED SCIENCES AND CLINICAL PRACTICE. IN ELABORATION OF SUCH MISSION, THE CORPORATION IS ESTABLISHED FOR THE BENEFIT OF AND TO SUPPORT THE TEACHING, RESEARCH AND PATIENT CARE MISSIONS OF RHODE ISLAND HOSPITAL (RIH), THE MIRIAM HOSPITAL (TMH), OTHER LIFESPAN AFFILIATED HOSPITALS, AND THE ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY. RIH, TMH, AND SUCH OTHER LIFESPAN AFFILIATED HOSPITALS ARE REFERRED TO COLLECTIVELY AS THE HOSPITALS. IN FURTHERANCE OF AND NOT IN LIMITATION OF THE FOREGOING PURPOSES, THE CORPORATION MAY ENGAGE IN ANY OTHER LAWFUL ACTIVITY THAT MAY BE CARRIED OUT BY A CORPORATION FORMED UNDER SECTION 7-6 OF THE GENERAL LAWS OF RHODE ISLAND, AS NOW WRITTEN OR HEREAFTER AMENDED, WHICH IS NOT INCONSISTENT WITH SECTION 501(C)(3) OF THE CODE, AND THE RULES AND REGULATIONS PROMULGATED THEREUNDER |
| NAICS: | 622110 - General Medical and Surgical Hospitals |
| Fictitious names: |
Brown Health Medical Group Primary Care (trading name, 2024-08-15 - ) Coastal Medical (trading name, 2021-06-25 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245008937 | 2023-12-13 | 2024-09-18 | 10 DAVOL SQ STE 300, PROVIDENCE, RI, 029034754, US | 10 DAVOL SQ STE 300, PROVIDENCE, RI, 029034754, US | |||||||||||||||||||||||||||||||
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| Phone | +1 401-421-4000 |
| Fax | 4012721456 |
Authorized person
| Name | CHRISTINE RAWNSLEY |
| Role | VP REVENUE CYCLE |
| Phone | 4014446905 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 133V00000X - Registered Dietitian |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PAUL J. ADLER | Agent | 245 CHAPMAN STREET SUITE 200, PROVIDENCE, RI, 02905, USA |
| Name | Role | Address |
|---|---|---|
| EDWARD MCGOOKIN M.D. | PRESIDENT | 3 RIVER MEADOW DRIVE HOPE VALLEY , RI 02832 USA |
| Name | Role | Address |
|---|---|---|
| G. DEAN ROYE M.D. | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Number | Name | File Date |
|---|---|---|
| 202458849880 | Fictitious Business Name Statement | 2024-08-15 |
| 202449067060 | Annual Report | 2024-03-14 |
| 202334043540 | Annual Report | 2023-04-26 |
| 202213203410 | Annual Report | 2022-03-21 |
| 202199505010 | Annual Report | 2021-07-23 |
| 202198664060 | Fictitious Business Name Statement | 2021-06-25 |
| 202033928490 | Articles of Incorporation | 2020-02-07 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
