NPIMap

Organization Active NPI

Emma Pendleton Bradley Hospital

  • Psychiatric Hospital
  • Riverside, RI
National Provider Identifier
1164627352
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
HOS00123 Issued in RI
Legal business name
EMMA PENDLETON BRADLEY HOSPITAL
Practice address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone
(401) 444-5640
NPI assigned
Jun 18, 2007
Organization subpart
Yes
Parent organization
LIFESPAN CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Peter K Markell
Title
Evp & Cfo
Phone
(401) 444-7914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X HOS00123 RI Primary

Addresses

Primary practice location

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Other identifiers 1

IdentifierTypeStateIssuer
BH46731MedicaidRI

National Provider Directory

National Provider Directory
Tax ID family
Carol J Jensen Cisw6 organizations share this tax ID, including this one
Part of
Lifespan Corporation

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1164627352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-444-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMA PENDLETON BRADLEY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESPAN CORPORATION",
        "enumeration_date": "2007-06-18",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "MARKELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "401-444-7914"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "RI",
            "license": "HOS00123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BH46731",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.