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TAVARES PEDIATRIC CENTER
NPI 1598368235
Intermediate Care Facility, Intellectual Disabilities in Providence, RI

Active since November 17, 2020CLIA 41D0681977 · Waiver
101 PLAIN ST, PROVIDENCE, RI 02903(401) 272-7127(401) 272-4752 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tavares Pediatric Center NPPES

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

TAVARES PEDIATRIC CENTER (NPI 1598368235) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Providence, Rhode Island and active in the NPI registry since November 2020. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Vivian M Tavares, Fin Adm, as its authorized official.

NPPES Registry Identity

NPI1598368235
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameTAVARES PEDIATRIC CENTER
Location Address101 PLAIN STProvidence, RI 02903-4828
Mailing Address101 Plain StProvidence, RI 02903-4828 · (401) 272-7127 · Fax (401) 272-4752
Phone(401) 272-7127
Fax(401) 272-4752
Organization SubpartNo
Authorized OfficialVivian M TavaresFin Adm · (401) 272-7127
Enumeration DateNovember 17, 2020
NPPES CertifiedNovember 17, 2020
✔ NPI 1598368235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
101 PLAIN ST, Providence, RI 02903
Open in Google Maps ↗

Other Names 1

Doing Business AsTavares Pediatric Center

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 41D0681977

Tavares Pediatric Center · Providence, RI
Active · expires Aug 31, 2026
CLIA Number41D0681977
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorErica Jewell
Laboratory Phone(401) 272-7127
Laboratory LocationTavares Pediatric Center101 Plain St, Providence, RI 02903
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 7

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

NINA MONEYMAKER NP
Nurse Practitioner (Women's Health)
101 PLAIN ST
PROVIDENCE, RI 02903
Providence County (401) 453-7560
TPC ASSOCIATES, INC.
Day Training, Developmentally Disabled Services
101 PLAIN ST
PROVIDENCE, RI 02903
Providence County (401) 273-7899
THE TAVARES PEDIATRIC CENTER INC
Intermediate Care Facility, Intellectual Disabilities
101 PLAIN ST
PROVIDENCE, RI 02903
Providence County (401) 272-7127
HANNAH B MCCONNELL RN, CDOE
Registered Nurse (Diabetes Educator)
101 PLAIN ST
PROVIDENCE, RI 02903
Providence County (401) 274-1122
CHARLES R RARDIN MD
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
101 PLAIN ST
PROVIDENCE, RI 02903
Providence County (401) 453-7560
ERIK ALEXANDER HOY MD, MBA
Plastic Surgery
101 PLAIN ST
PROVIDENCE, RI 02903
Providence County (401) 736-4592
DR. DWIGHT J ROUSE MD, MSPH
Obstetrics & Gynecology (Maternal & Fetal Medicine)
101 PLAIN ST
PROVIDENCE, RI 02903
Providence County (401) 274-1122

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 Tavares Pediatric Center's NPI number?

The NPI number for Tavares Pediatric Center is 1598368235. It was assigned to this organization in the NPPES registry on November 17, 2020.

Where is Tavares Pediatric Center located?

Tavares Pediatric Center is located at 101 Plain St, Providence, RI 02903. The listed phone number is (401) 272-7127.

What is Tavares Pediatric Center's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Tavares Pediatric Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 41D0681977) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tavares Pediatric Center was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.