Active NPI
Memorial Hospital
Doing business as Memorial Hospital of Rhode Island
- General Acute Care Hospital
- Pawtucket, RI
National Provider Identifier
1063441640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- HOS00128
- Legal business name
- MEMORIAL HOSPITAL
- Doing business as
- Memorial Hospital of Rhode Island
- Practice address
- 111 Brewster St
Pawtucket, RI 02860-4400 - Phone
- (401) 729-2836
- Fax
- (401) 729-2721
- NPI assigned
- Jul 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Francis R Dietz
- Title
- Ceo/ President
- Phone
- (401) 729-2130
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | |||
| Emergency Medicine Physician | 207P00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Hematology & Oncology Physician | 207RH0003X | |||
| Infectious Disease Physician | 207RI0200X | |||
| Pulmonary Disease Physician | 207RP1001X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Pediatrics Physician | 208000000X | |||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Public Health & General Preventive Medicine Physician | 2083P0901X | |||
| Neurology Physician | 2084N0400X | |||
| General Practice Physician | 208D00000X | |||
| Hospitalist Physician | 208M00000X | |||
| General Acute Care Hospital | 282N00000X | HOS00128 | RI | Primary |
Addresses
Primary practice location
111 Brewster St
Pawtucket, RI 02860-4400
Mailing address
PO Box 1908
Pawtucket, RI 02862-1908
Phone (401) 729-2836
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7000979 | Medicaid | MA | |
| 410001 | Medicaid | RI | |
| 7200811 | Medicaid | MA | |
| MH11562 | Medicaid | RI |
Other names 1
- Memorial Hospital of Rhode Island
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1196380800000",
"number": "1063441640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1908",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028621908",
"telephone_number": "401-729-2836",
"fax_number": "701-729-2721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 BREWSTER ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604400",
"telephone_number": "401-729-2836",
"fax_number": "401-729-2721"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEMORIAL HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-03",
"last_updated": "2007-11-30",
"status": "A",
"authorized_official_last_name": "DIETZ",
"authorized_official_first_name": "FRANCIS",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO/ PRESIDENT",
"authorized_official_telephone_number": "401-729-2130",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083P0901X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
},
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "RI",
"license": "HOS00128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7000979",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "410001",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7200811",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MH11562",
"state": "RI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Memorial Hospital of Rhode Island",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.