KOANN THERAPEUTIC SERVICES INC
KOANN THERAPEUTIC SERVICES INC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1639843303, based in Providence, RI. The organization lists 7 taxonomy classifications, with Psychiatric/Mental Health Nurse Practitioner recorded as primary.
Getting there
The practice address on file is 845 N MAIN ST, Providence, RI 02904. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 7113302282
Enrolled in Medicare 3 times, across 3 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Rhode Island | O20220912000255 | Part B Supplier - Clinic/group Practice |
| Massachusetts | O20250508002881 | Part B Supplier - Clinic/group Practice |
| Maryland | O20250520000646 | Part B Supplier - Clinic/group Practice |
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. There are 3 separate enrolment records across 3 states (RI, MA, MD). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Psychiatric/Mental Health covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LP0808X
All registered taxonomy codes
This provider registers 7 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 261QM1300X | Multi-Specialty Clinic/Center Multi-Specialty | — | — | |
| 163WP0807X | Child & Adolescent Psychiatric/Mental Health Registered Nurse Psychiatric/Mental Health, Child & Adolescent | — | — | |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) Mental Health (Including Community Mental Health Center) | — | — | |
| 163W00000X | Registered Nurse | — | — | |
| 251B00000X | Case Management Agency | — | — | |
| 163WP0809X | Adult Psychiatric/Mental Health Registered Nurse Psychiatric/Mental Health, Adult | — | — | |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner Psychiatric/Mental Health | — | — | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1639843303 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Aug 5, 2021 |
| Last updated | Jan 12, 2026 |
| Status | Active |
| Practice address |
845 N MAIN ST Providence, RI 02904 (401) 648-7172 Fax (401) 648-0161 |
| Mailing address |
PO BOX 3085 Pawtucket, RI 02861 |
| Other names |
Revive Therapeutic Services Former Legal Name |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 3 | 9 | 8 | 4 | 3 | 3 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 6 | 9 | 7 | 4 | 6 | 3 | 0 |
Sum = 67 · next multiple of 10 = 70 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.