NPIMap

Organization Active NPI

Memorial Hospital

  • Cardiovascular Disease Physician
  • Pawtucket, RI
National Provider Identifier
1902026701
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MEMORIAL HOSPITAL
Practice address
111 Brewster St
Pawtucket, RI 02860-4400
Phone
(401) 729-2000
NPI assigned
Apr 26, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

111 Brewster St
Pawtucket, RI 02860-4400

Mailing address

111 Brewster St
Pawtucket, RI 02860-4400
Phone (401) 729-2000

Other identifiers 1

IdentifierTypeStateIssuer
9006183MedicaidRI

Other names 1

  • Memorial Hospital Cardiology Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1902026701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-729-2000"
        },
        {
            "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": "401-729-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "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": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006183",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hospital Cardiology",
            "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.