| Name: | Rhode Island Health Group, P.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 20 Jul 2020 (5 years ago) |
| Date of Dissolution: | 12 Oct 2022 (3 years ago) |
| Date of Status Change: | 12 Oct 2022 (3 years ago) |
| Identification Number: | 001710975 |
| ZIP code: | 02896 |
| County: | Providence County |
| Principal Address: | 63-65 EDDIE DOWLING HIGHWAY, NORTH SMITHFIELD, RI, 02896, USA |
| Purpose: | MEDICAL PRACTICE |
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 | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982216974 | 2020-08-20 | 2023-10-10 | 63 EDDIE DOWLING HWY STE 1, NORTH SMITHFIELD, RI, 028967322, US | 65 EDDIE DOWLING HWY, NORTH SMITHFIELD, RI, 028967305, US | |||||||||||||||||||||||||
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| Phone | +1 401-597-5353 |
| Fax | 4017694555 |
Authorized person
| Name | MUHAMMAD IMRAN CHAUDRY |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 4015975353 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 710001102 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| NASIR BHATTI, M.D. | Agent | 63-65 EDDIE DOWLING HIGHWAY, NORTH SMITHFIELD, RI, 02896, USA |
| Name | Role | Address |
|---|---|---|
| NASIR BHATTI MD | PRESIDENT | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| Name | Role | Address |
|---|---|---|
| SYED IFTIKHAR HUSSAIN MD | SECRETARY | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| Name | Role | Address |
|---|---|---|
| NASIR BHATTI MD | DIRECTOR | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| SYED IFTIKHAR HUSSAIN MD | DIRECTOR | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| Number | Name | File Date |
|---|---|---|
| 202223973680 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-10-12 |
| 202220255220 | Revocation Notice For Failure to File An Annual Report | 2022-06-27 |
| 202198506900 | Statement of Change of Registered/Resident Agent | 2021-06-22 |
| 202198506630 | Annual Report | 2021-06-22 |
| 202197047080 | Revocation Notice For Failure to File An Annual Report | 2021-05-19 |
| 202050499410 | Certificate of Correction | 2020-08-28 |
| 202050458390 | Statement of Change of Registered/Resident Agent | 2020-08-28 |
| 202047536490 | Articles of Incorporation | 2020-07-20 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
