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NPI Code Detail

MEDICARE: THE MIRIAM HOSPITAL

MEDICARE: THE MIRIAM HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician
2101YM0800XMental Health Counselor
3133V00000XRegistered Dietitian
4163WP0809XAdult Psychiatric/Mental Health Registered Nurse
51041C0700XClinical Social Worker
62084P0800XPsychiatry Physician
7364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist
8207R00000XInternal Medicine Physician
9363AM0700XMedical Physician Assistant
10103TC0700XClinical Psychologist
112084N0400XNeurology Physician
12363A00000XPhysician Assistant
13282N00000XGeneral Acute Care Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225073638
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE MIRIAM HOSPITAL
Provider Business Mailing Address
First Line : 15 LA SALLE SQ
Second Line :
City : PROVIDENCE
State : RI
Zip : 02903-1814
Country : US
Telephone Number : 401-444-6779
Fax Number : 401-444-6912
Provider Business Practice Location Address
First Line : 146 W RIVER ST STE 11A
Second Line :
City : PROVIDENCE
State : RI
Zip : 02904-2609
Country : US
Telephone Number : 401-793-8770
Fax Number : 401-793-8709
Authorized Official
Title or Position : EVP & CFO
Name : PETER M MARKELL
Credential :
Telephone Number : 401-444-7914
Provider Enumeration Date : 06/19/2006
Last Update Date : 12/11/2025

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1992794408 — JEREMY SPECTOR M.D.
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1023007556 — NEIL ROBERT GREENSPAN M.D.
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Directions to “THE MIRIAM HOSPITAL ” Practice Location

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