THE MIRIAM HOSPITAL (NPI# 1548481427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548481427 |
| Entity Type | Organization |
| Organization Name | THE MIRIAM HOSPITAL |
| Other Organization Name | BEHAVIORAL HEALTH |
| Practice Address |
164 Summit Ave Providence RI 02906-2853 |
| Mailing Address |
117 Ellenfield St Providence RI 02905-4513 |
| Practice Telephone | 4014445640 |
| Practice Fax Number | 4014445462 |
| Mailing Telephone | 4014445640 |
| Mailing Fax Number | 4014445462 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2016-03-17 |
| Authorized Official Name | MRS. MARY A WAKEFIELD (EXECUTIVE VP & CFO) |
| Authorized Official Telephone | 4014445640 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE MIRIAM HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | HOS0012207 | RI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | BCBSRI GRP NUMBER | 0000003325 | 01 |
| Other Name | Type Code |
|---|---|
| Behavioral Health | Other Name - Individual/Organization |
| 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 |
| 1225073638 | The Miriam Hospital | Clinical Nurse Specialist | 146 W River St Ste 11a, Providence, RI 02904-2609 | 2006-06-19 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THE MIRIAM HOSPITAL | 164 Summit Ave, Providence, RI 02906-2894 |
| Street Address |
164 SUMMIT AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-2853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558369512 | Josephine Salhab | Physician Assistant | 164 Summit Ave, Rm C70, Providence, RI 02906-2853 | 2005-07-13 |
| 1619519865 | Sarah Mcnerney | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2019-10-09 |
| 1831743095 | Tracy Lynn Carraggi | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2853 | 2019-07-26 |
| 1689233975 | Nicole Parascandolo | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2894 | 2019-06-10 |
| 1164992558 | Lisha Andrew | Dietitian, Registered | 164 Summit Ave, Providence, RI 02906-2894 | 2018-11-28 |
| 1689156242 | Monique Coley | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2894 | 2018-08-30 |
| 1235615006 | Sameh Mohamed | Internal Medicine | 164 Summit Ave, Providence, RI 02906-2894 | 2018-07-16 |
| 1578058087 | Noor N Safadi | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2018-06-27 |
| 1356847172 | Heidi Jimenez | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-04-02 |
| 1831694439 | Laura Canavan | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922508373 | Acupuncture Ri Ltd. | Clinic/Center | 102 Gano St, Providence, RI 02906-3807 | 2018-02-12 |
| 1477098911 | Rhode Island Neurodiagnostics, LLC | Clinic/Center | 10 Dorrance St., Ste. 700, Office 707, Providence, RI 02903-2014 | 2016-12-19 |
| 1467864884 | Providence Community Acupuncture, LLC | Clinic/Center | 22 Parsonage St, Providence, RI 02903-4732 | 2014-05-21 |
| 1114243599 | Occupational Health Services of The Southwest Pa | Clinic/Center | 290 Branch Ave, Providence, RI 02904 | 2010-04-11 |
| 1902027808 | The Miriam Hospital | Clinic/Center | 11 Summit Ave, Providence, RI 02906-2506 | 2007-05-01 |
| 1669024329 | The Rhode Island Public Health Foundation | Clinic/Center | 7 Central St, Providence, RI 02907-2201 | 2019-07-12 |
| 1003239286 | Kevin E. Baill Md & Associates, LLC | Clinic/Center | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2014-01-24 |
| 1851721740 | Passport Health Holdings LLC | Clinic/Center | 100 Highland Ave, Suite 303, Providence, RI 02906-2753 | 2013-11-14 |
| 1558706267 | Rhode Island Free Clinic, Inc | Clinic/Center | 655 Broad St, Providence, RI 02907-1444 | 2013-05-08 |
| 1649538323 | The Miriam Hospital | Clinic/Center | 146 W River St, Providence, RI 02904-2609 | 2012-05-01 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
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.