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CODAC NEWPORT
NPI 1043436785
Clinic/Center - Methadone in Newport, RI

Active since April 18, 2007CLIA 41D2064052 · Waiver
93 THAMES ST, CODAC NEWPORT, NEWPORT, RI 02840(401) 846-4150(401) 846-9340 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 21, 2021, Apr 25, 2019, Sep 22, 2017 and 1 more (4 updates tracked since 2017).

About Codac Newport NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CODAC NEWPORT (NPI 1043436785) is a healthcare organization registered as a methadone in Newport, Rhode Island and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through August 13, 2027 and lists Alisha M Bourdeau, Cfo, as its authorized official.

NPPES Registry Identity

NPI1043436785
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameCODAC INC
Location Address93 THAMES ST, CODAC NEWPORTNewport, RI 02840
Mailing Address1052 Park AveCranston, RI 02910 · (401) 275-5038 · Fax (401) 942-3590
Phone(401) 846-4150
Fax(401) 846-9340
Organization SubpartNo
Authorized OfficialAlisha M BourdeauCfo · (401) 275-5038
Enumeration DateApril 18, 2007
Last NPPES UpdateDecember 21, 20214 updates tracked since enumeration
NPPES CertifiedDecember 21, 2021
✔ NPI 1043436785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Licenses✔ Licensed in RI · 605.04✔ Licensed in RI · 605.4
Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Also ListedPeer SpecialistTaxonomy 175T00000X
Also ListedFamily Medicine · Addiction MedicineTaxonomy 207QA0401X · License ACF01632-05 (RI)
Also ListedPublic Health or WelfareTaxonomy 251K00000X · License 605.4 (RI)
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License ACF01632-05 (RI)
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X · License 605.04 (RI), 605.4 (RI)
Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X · License 605.4 (RI)
93 THAMES ST, Newport, RI 02840
Open in Google Maps ↗

Other Names 1

Doing Business AsCodac Newport

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 41D2064052

Codac · Cranston, RI
Active · expires Aug 13, 2027
CLIA Number41D2064052
Laboratory TypeOpioid Treatment
Certificate Effective DateAugust 14, 2025
Certificate Expiration DateAugust 13, 2027
Laboratory DirectorCatherine Degood
Laboratory Phone(401) 275-5038
Laboratory LocationCodac1052 Park Ave Attn Diane, Cranston, RI 02910
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL ANTHONY MCGOURTY PA-C
Physician Assistant (Medical)
93 THAMES ST
NEWPORT, RI 02840
Newport County (401) 846-4150
MR. JOHN P FELD LCDP00450
Counselor (Addiction (Substance Use Disorder))
93 THAMES ST
NEWPORT, RI 02840
Newport County (401) 846-4150

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Codac Inc's NPI number?

The NPI number for Codac Inc is 1043436785. It was assigned to this organization in the NPPES registry on April 18, 2007. The provider is doing business as Codac Newport.

Where is Codac Inc located?

Codac Inc is located at 93 Thames St Codac Newport, Newport, RI 02840. The listed phone number is (401) 846-4150.

What is Codac Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does Codac Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 41D2064052) is associated with this NPI, valid through August 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Codac Inc was last updated on December 21, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.