THE MIRIAM HOSPITAL (NPI# 1225073638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225073638 |
| Entity Type | Organization |
| Organization Name | THE MIRIAM HOSPITAL |
| Practice Address |
146 W River St Ste 11a Providence RI 02904-2609 |
| Mailing Address |
117 Ellenfield St Suite 101, Credentialing Department Providence RI 02905-4513 |
| Practice Telephone | 4017938770 |
| Practice Fax Number | 4017938709 |
| Mailing Telephone | 4014446779 |
| Mailing Fax Number | 4014446912 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | MARY A. WAKEFIELD (EXECUTIVE VP & CFO) |
| Authorized Official Telephone | 4014447093 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
Nursing Service Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | MI72815 - PSYCH | 05 | |
| RI | 1225073638 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518482389 | The Miriam Hospital | Clinic/Center | 1454 S County Trl Ste 1100, East Greenwich, RI 02818-1750 | 2017-08-14 |
| 1902027808 | The Miriam Hospital | Clinic/Center | 11 Summit Ave, Providence, RI 02906-2506 | 2007-05-01 |
| 1568567790 | The Miriam Hospital | Nurse Practitioner | 14 Third Street, Providence, RI 02906-2738 | 2006-09-13 |
| 1588088850 | The Miriam Hospital | Internal Medicine | 164 Summit Ave, Fain Bldg, Providence, RI 02906-2853 | 2014-02-07 |
| 1740615277 | The Miriam Hospital | General Acute Care Hospital | 164 Summit Ave, Providence, RI 02906-2853 | 2013-09-03 |
| 1669726451 | The Miriam Hospital | Clinic/Center | 164 Summit Ave, 2rd Floor Fain Building, Providence, RI 02906-2853 | 2012-11-01 |
| 1649538323 | The Miriam Hospital | Clinic/Center | 146 W River St, Providence, RI 02904-2609 | 2012-05-01 |
| 1275810434 | The Miriam Hospital | Psychiatry & Neurology | 1125 N Main St, Providence, RI 02904-5739 | 2011-11-15 |
| 1851677470 | The Miriam Hospital | Internal Medicine | 208 Collyer St, Suite 100, Providence, RI 02904-1560 | 2011-10-27 |
| 1164716031 | The Miriam Hospital | Clinic/Center | 146 W River St, Providence, RI 02904-2609 | 2011-06-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THE MIRIAM HOSPITAL | 164 Summit Ave, Providence, RI 02906-2894 |
| Street Address |
146 W RIVER ST STE 11A |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02904-2609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982254215 | Lora Wu | Psychologist | 146 W River St Ste 11a, Providence, RI 02904-2609 | 2019-09-18 |
| 1336608843 | Sarah Catherine Pillemer | Clinical Neuropsychologist | 146 W River St Ste 11a, Providence, RI 02904-2609 | 2019-03-14 |
| 1578037958 | Camille Gregorian | Social Worker | 146 W River St Ste 11a, Providence, RI 02904-2609 | 2019-01-18 |
| 1952819484 | Seth Aaron Margolis | Clinical Neuropsychologist | 146 W River St Ste 11a, Providence, RI 02904 | 2018-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144792383 | Lifespan Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 180 Corliss Street, Suite A, Providence, RI 02904 | 2018-12-28 |
| 1780168229 | Beth M. Kalunian | Social Worker | 480 Charles Street, Providence, RI 02904 | 2018-09-20 |
| 1588161608 | Michael P. Johnson, Md, Inc | Internal Medicine | 148 W River St Ste 22b, Providence, RI 02904 | 2018-04-06 |
| 1780045948 | Fred Saccoccio | Pharmacist | 15 Smithfield Road, No Providence, RI 02904 | 2016-03-16 |
| 1699148999 | Latin Adult Day Health Care Center | Clinic/Center | 665 Charles Street, Providence, RI 02904 | 2015-11-09 |
| 1144639956 | Dina P Toolin | Occupational Therapist | 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 | 2014-08-06 |
| 1801208798 | Seth Clark | Internal Medicine | 200 Corliss St, Providence, RI 02904 | 2014-05-27 |
| 1134554645 | Molly Elizabeth Smith | Physical Therapist | 1405 Douglas Ave, North Providence, RI 02904 | 2013-09-04 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| 1598036790 | Joseph F. Osmanski, Od, Inc | Optometrist | 1971 Mineral Spring Avenue, N. Providence, RI 02904 | 2012-01-19 |
| Find all providers in zip 02904 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609953397 | Rhode Island Hospital | General Acute Care Hospital | 1 Hoppin St Ste 200, Providence, RI 02903-4132 | 2006-11-01 |
| 1104233832 | Rhode Island Hospital | General Acute Care Hospital | 593 Eddy St, Children's Neurodevelopment Center, Providence, RI 02903-4923 | 2014-07-15 |
| 1013332014 | Prospect Chartercare Rwmc, LLC | General Acute Care Hospital | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2014-02-27 |
| 1740615277 | The Miriam Hospital | General Acute Care Hospital | 164 Summit Ave, Providence, RI 02906-2853 | 2013-09-03 |
| 1063853661 | Roger Williams Medical Center | General Acute Care Hospital | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2013-07-11 |
| 1003103391 | Rhode Island Hospital | General Acute Care Hospital | 593 Eddy St, Main 4, Providence, RI 02903 | 2011-07-07 |
| 1023325800 | Rhode Island Hospital | General Acute Care Hospital | 17 Seekonk St, Providence, RI 02906-5125 | 2010-09-01 |
| 1366674509 | Anita Susan Kestin | General Acute Care Hospital | 167 Point St, Suite 213, Providence, RI 02903-4771 | 2009-08-21 |
| 1629218094 | Women and Infants Hospital | General Acute Care Hospital | 101 Dudley St, Providence, RI 02905-2401 | 2009-02-25 |
| 1225184617 | St. Joseph Health Services of Ri | General Acute Care Hospital | 21 Peace St, Providence, RI 02907-1510 | 2007-01-26 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02904 |
Please comment or provide details below to improve the information on THE MIRIAM HOSPITAL.
| 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.