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KEITH B SUNDERLIN PAC
NPI 1093707655
Physician Assistant in Providence, RI

Active since August 19, 2005
593 EDDY ST, APC 4, PROVIDENCE, RI 02903(401) 444-4000(401) 444-6681 Get Directions Write a Review

NPPES record last updated: October 22, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Keith B Sunderlin Pac NPPES

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

KEITH B SUNDERLIN PAC (NPI 1093707655) is an individual physician assistant in Providence, Rhode Island, licensed in Rhode Island (PA00417) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1093707655
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKEITH B SUNDERLINCredential: PAC
Location Address593 EDDY ST, APC 4Providence, RI 02903-4923
Mailing AddressPo Box 16149Rumford, RI 02916-0697 · (401) 453-9625 · Fax (401) 435-7069
Phone(401) 444-4000
Fax(401) 444-6681
Sole ProprietorNo
Enumeration DateAugust 19, 2005
Last NPPES UpdateOctober 22, 2010
✔ NPI 1093707655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in RI · PA00417✔ Licensed in NC · 102283
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
593 EDDY ST, Providence, RI 02903
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Other Identifiers 3

Medicaid9005145RI
Medicare PIN979005145RI
Medicare ID-Type Unspecified2744096ANC

Other Providers at the Same Location NPPES 20

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

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRIAN CAO MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-4286
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695

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 Keith Sunderlin's NPI number?

The NPI number for Keith Sunderlin is 1093707655. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Where is Keith Sunderlin located?

Keith Sunderlin practices at 593 Eddy St Apc 4, Providence, RI 02903. The listed phone number is (401) 444-4000.

What is Keith Sunderlin's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Keith Sunderlin was last updated on October 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.