Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lifespan Physician Group, Inc

Organization Registered Dietitian · NPI 1407116643

Lifespan Physician Group, Inc is a Registered Dietitian in Providence, Rhode Island. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
15
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-6779
Fax: (401) 444-6912
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Registered Dietitian Taxonomy 133V00000X
Optometrist Taxonomy 152W00000X
Transplant Surgery Physician Taxonomy 204F00000X
Critical Care Medicine (Anesthesiology) Physician Taxonomy 207LC0200X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Plastic Surgery Physician Taxonomy 208200000X
Surgery Physician Taxonomy 208600000X
Surgical Critical Care Physician Taxonomy 2086S0102X
Pediatric Surgery Physician Taxonomy 2086S0120X
Trauma Surgery Physician Taxonomy 2086S0127X
Vascular Surgery Physician Taxonomy 2086S0129X
Surgical Oncology Physician Taxonomy 2086X0206X
Colon & Rectal Surgery Physician Taxonomy 208C00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X

Record details

NPI number1407116643
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLifespan Corporation
Authorized official Peter Markell — Evp & Cfo · (401) 444-7914
Other names Brown Health Medical Group
NPI enumeratedMay 22, 2012
Last updated in NPPESOctober 7, 2025
Certification dateOctober 7, 2025
Mailing address117 Ellenfield St, Suite 101, Providence, RI 02905-4513

Other providers in Providence