NPIMap

Organization Active NPI

Memorial Hospital

  • Internal Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1518176874
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEMORIAL HOSPITAL
Practice address
111 Brewster Street
Pawtucket, RI 02860
Phone
(401) 729-2000
NPI assigned
May 22, 2007
Last updated
Dec 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Neurology Physician 2084N0400X NU

Addresses

Primary practice location

111 Brewster Street
Pawtucket, RI 02860

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
MH11562MedicaidRI

Other names 1

  • Memorial Hospital of Rhode Island Other name

National Provider Directory

National Provider Directory
Tax ID family
Eleanor M Summerhill MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 15

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 15

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": "1199059200000",
    "number": "1518176874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BREWSTER STREET",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-729-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER STREET",
            "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": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT-CEO",
        "authorized_official_telephone_number": "401-729-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH11562",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hospital of Rhode Island",
            "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 Dec 31, 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.