Provider Demographics
NPI:1568457224
Name:GAINES, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:GAINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:41 SANDERSON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-2602
Practice Address - Country:US
Practice Address - Phone:404-949-0300
Practice Address - Fax:401-369-7963
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI110184848OtherRAILROAD MEDICARE
RI428-6OtherBCBS OF RI
RIJG18500Medicaid
RI202213OtherBLUE CHIP
RI404476OtherTUFTS HEALTH PLAN
RI04-00477OtherUNITED HEALTH CARE
RI20850OtherNEIGHBORHOOD HEALTH PLAN
RI60537OtherHARVARD HEALTH PLAN
RI751395OtherHEALTH CARE VALUE MGMT
RI050483739OtherGREAT WEST HEALTH CARE
RI709004048OtherMEDICARE GROUP
RI710039601OtherCIGNA
RI428-6OtherBCBS OF RI
RI710039601OtherCIGNA