NPIMap

Organization Active NPI

Memorial Hospital

  • General Practice Physician
  • Pawtucket, RI
National Provider Identifier
1396954640
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEMORIAL HOSPITAL
Practice address
111 Brewster Street
Memorial Hospital of Rhode Island
Pawtucket, RI 02860
Phone
(401) 729-2000
NPI assigned
May 22, 2007
Last updated
Nov 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Francis R Dietz
Title
Ceo/President
Phone
(401) 729-2000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Obstetrics & Gynecology Physician 207V00000X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

111 Brewster Street
Memorial Hospital of Rhode Island
Pawtucket, RI 02860

Mailing address

174 Armstice Blvd.
Pawtucket, RI 02860
Phone (401) 729-3600

Other identifiers 1

IdentifierTypeStateIssuer
MH11562MedicaidRI

Other names 1

  • Primary Care Ctr.. of Quality Hill and Womens Health Specialists Other name

National Provider Directory

National Provider Directory

Locations

111 Brewster St
Pawtucket, RI 02860
Phone (401) 729-2000

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1396954640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 ARMSTICE BLVD.",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-729-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER STREET",
            "address_2": "MEMORIAL HOSPITAL OF RHODE ISLAND",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-729-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "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": "401-729-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH11562",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Ctr.. of Quality Hill and Womens Health Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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.

Verify at the official NPI Registry.