NPIMap

Organization Active NPI

The Miriam Hospital

  • Medical Specialty Clinic/Center
  • Providence, RI
National Provider Identifier
1275810434
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
HOS00122 Issued in RI
Legal business name
THE MIRIAM HOSPITAL
Practice address
180 Corliss St Ste E1
Providence, RI 02904-2602
Phone
(401) 793-7401
NPI assigned
Nov 15, 2011
Last updated
Dec 11, 2025By the provider in NPPES
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
Mr. Peter K Markell
Title
Evp & Cfo
Phone
(401) 444-7914

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X HOS00122 RI Primary
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

180 Corliss St Ste E1
Providence, RI 02904-2602

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (014) 446-7794

Other practice location 1

180 Corliss St Ste F
Providence, RI 02904-2602
Phone (401) 793-4715

Other practice location 2

180 Corliss St Ste E2
Providence, RI 02904-2602
Phone (401) 793-2928

Other names 1

  • Immunology Center at The Miriam Hospital Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120405000306 RI Part B Supplier - Hospital Department(S) 6901796408 Receives reassigned benefits from 48 practitioners
Practice locations: Providence, RI

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Lifespan Corporation

Locations

1125 N Main St
Providence, RI 02904
Phone (401) 793-2928

180 Corliss St
Ste E1
Providence, RI 02904
Phone (401) 793-2928

180 Corliss St
Ste E2
Providence, RI 02904
Phone (401) 793-2928

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1275810434",
    "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": "014-446-7794",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CORLISS ST STE E1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042602",
            "telephone_number": "401-793-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Corliss St Ste F",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029042602",
            "country_code": "US",
            "telephone_number": "401-793-4715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 Corliss St Ste E2",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029042602",
            "country_code": "US",
            "telephone_number": "401-793-2928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE MIRIAM HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESPAN CORPORATION",
        "enumeration_date": "2011-11-15",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "RI",
            "license": "HOS00122",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Immunology Center at The Miriam Hospital",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Immunology Center at The Miriam Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Providence, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.