MEMORIAL HOSPITAL (NPI# 1043430929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043430929 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL |
| Other Organization Name | EMERGENCY ROOM MEDICAL STAFF |
| Practice Address |
Memorial Hospital of Rhode Island 111 Brewster Street Pawtucket RI 02860-4400 |
| Practice Telephone | 4017292000 |
| Mailing Telephone | 4017292000 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2007-11-30 |
| Authorized Official Name | MR. FRANCIS R DIETZ (CEOPRESIDENT) |
| Authorized Official Telephone | 4017292000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 9001088 | 05 |
| Other Name | Type Code |
|---|---|
| Emergency Room Medical Staff | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528447992 | Memorial Hospital | General Acute Care Hospital | 1400 E. Boulder St. #3138, Colorado Springs, CO 80045 | 2015-05-19 |
| 1629469002 | Memorial Hospital | Family Medicine | 2319 Old Plank Road, Chester, IL 62233-1116 | 2015-02-06 |
| 1609073709 | Memorial Hospital | Nurse Practitioner | 9099 E Lansing Rd Ste B, Durand, MI 48429-1083 | 2007-07-02 |
| 1003025883 | Memorial Hospital | Psychiatric Residential Treatment Facility | 806 Central Ave Se, Albuquerque, NM 87102-3606 | 2007-05-21 |
| 1376759563 | Memorial Hospital | Family Medicine | 86 Savannah Lane, Bulan, KY 41722 | 2007-05-15 |
| 1598977787 | Memorial Hospital | Family Medicine | 3337 W Britton Rd, Perry, MI 48872 | 2007-05-03 |
| 1639209232 | Memorial Hospital | Internal Medicine | 1480 N M 52, Owosso, MI 48867-1235 | 2007-03-06 |
| 1306973805 | Memorial Hospital | Physician Assistant | 207 Shirlwood Dr, Schenectady, NY 12306-3417 | 2007-02-28 |
| 1851338149 | Memorial Hospital | General Acute Care Hospital | 715 South Taft Avenue, Fremont, OH 43420-3200 | 2006-06-02 |
| 1316923485 | Memorial Hospital | Hospice Care, Community Based | 1412 6th Ave, York, PA 17403-2648 | 2005-12-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL | 224 E 2nd St, Dumas, TX 79029-3808 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL & HEALTH CARE CENTER | 800 W 9th St, Jasper, IN 47546-2514 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND COMMUNITY HEALTH FOUNDATION INC | 112 East Fifth Avenue, Antigo, WI 54409-2710 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND HOMES ASSOCIATION, INC. | 415 8th Ave Sw, Perham, MN 56573-1156 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MANOR | 1500 E Shotwell St, Bainbridge, GA 39819-4256 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MEDICAL CENTER | 400 Rosalind Redfern Grover Parkway, Midland, TX 79701-5846 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AT GULFPORT | 4500 13th St, Gulfport, MS 39501-2515 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL CENTRAL | 1400 E Boulder St, Colorado Springs, CO 80909-5533 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL EAST | 1404 Cross St, Shiloh, IL 62269-2988 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL FOR CANCER & ALLIED DISEASES | 1275 York Ave, New York, NY 10065-6007 |
| Street Address |
MEMORIAL HOSPITAL OF RHODE ISLAND 111 BREWSTER STREET |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02860-4400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619909108 | Melissa M Amick | Clinical Neuropsychologist | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860 | 2006-07-07 |
| 1306914130 | James E Carney | Physician Assistant | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860 | 2006-12-01 |
| 1518061787 | Alicia J Curtin | Nurse Practitioner | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860 | 2006-09-11 |
| 1538275854 | Taro Minami | Internal Medicine | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860-4499 | 2006-08-21 |
| 1811003288 | Joshua Justice Lee | Internal Medicine | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860-4499 | 2006-08-21 |
| 1104931476 | Bhupesh Dhananjayan | Internal Medicine | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860-4499 | 2006-08-20 |
| 1942224639 | Janet Grace | Clinical Neuropsychologist | Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972096923 | Lmb Medical LLC | Internal Medicine | 127 School St, Pawtucket, RI 02860 | 2018-06-13 |
| 1215420435 | Tyla Jackson | Behavior Technician | 70 Wood St Apt 22, Pawtucket, RI 02860 | 2018-06-12 |
| 1376048637 | Michael A Iadevaia | Family Medicine | 111 Brewster St Fl 3, Pawtucket, RI 02860 | 2018-03-28 |
| 1730690488 | Anthony Edwin Ramicone | Physician Assistant | 407 East Ave Ste 120, Pawtucket, RI 02860 | 2017-10-21 |
| 1669991352 | Kathleen K. Kroessler, Md; Neurology & Acupuncture, Inc. PC | Clinic/Center | 407 East Ave; Suite 110, Pawtucket, RI 02860 | 2017-09-13 |
| 1841716230 | Ri Alternative Academy Management, LLC | Local Education Agency (LEA) | 249 Roosevelt Avenue, Pawtucket, RI 02860 | 2017-08-17 |
| 1396265724 | Hannah R Stoops | Family Medicine | 111 Brewster St Fcc A, Pawtucket, RI 02860 | 2017-06-27 |
| 1427578400 | Shaun Michael Flynn | Family Medicine | 111 Brewster St, Fcc A, Pawtucket, RI 02860 | 2017-06-21 |
| 1073051843 | Laura Jane Amaral | Counselor | 750 East Ave Unit 1e, Pawtucket, RI 02860 | 2017-02-01 |
| 1063862027 | Stephanie Shoppell | Counselor | 105 Bacon Street, Pawtucket, RI 02860 | 2016-06-20 |
| Find all providers in zip 02860 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700094992 | Shadi Kiriaki | Emergency Medicine | 92 Darlingdale Ave, Pawtucket, RI 02861-1906 | 2007-05-19 |
| 1548571813 | Katie Chapman | Emergency Medicine | 111 Brewster St, Pawtucket, RI 02860-4474 | 2010-07-01 |
| 1477766749 | Amir Bernaba | Emergency Medicine | 111 Brewster St, Pawtucket, RI 02860-4400 | 2007-05-07 |
| 1285847467 | Laura Forman | Emergency Medicine | 111 Brewster St, Pawtucket, RI 02860-4474 | 2007-05-07 |
| 1508081498 | Megan Mcnamara | Emergency Medicine | 111 Brewster St, Emergency Department, Pawtucket, RI 02860-4400 | 2007-04-16 |
| 1730221151 | Patrick Smith Zelley | Emergency Medicine | 111 Brewster St, Emergency Department, Pawtucket, RI 02860-4400 | 2007-02-13 |
| 1225188014 | James P O'hair | Emergency Medicine | 100 Smithfield Ave, Pawtucket, RI 02860-3497 | 2007-01-12 |
| 1033226444 | Michael S Siclari | Emergency Medicine | 111 Brewster Street, Pawtucket, RI 02860-4400 | 2006-08-23 |
| 1336188333 | Kristin Lynch Gregg | Emergency Medicine | 111 Brewster Street, Pawtucket, RI 02860-4400 | 2006-06-05 |
| 1033194105 | John Riedel | Emergency Medicine | 111 Brewster St, Department of Emergency Medicine, Pawtucket, RI 02860-4400 | 2005-12-13 |
| Find all providers in PAWTUCKET | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.