LIFESPAN PHYSICIAN GROUP, INC.
NPI 1174484216
Surgery in Providence, RI
NPI Status: Active since November 19, 2025
Contact Information
2 DUDLEY ST STE 470
PROVIDENCE, RI
ZIP 02905
Phone: (401) 272-1800
Fax: (401) 751-5124
- Organization
- Surgery
- CLIA Number: 41D2041521
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-24-2028
About LIFESPAN PHYSICIAN GROUP, INC.
This page provides the complete NPI Profile along with additional information for Lifespan Physician Group, Inc., a provider established in Providence, Rhode Island operating as a Surgery. The healthcare provider is registered in the NPI registry with number 1174484216 assigned on November 2025. The practitioner's primary taxonomy code is 208600000X. The provider is registered as an organization and their NPI record was last updated one year ago. Lifespan Physician Group, Inc. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Christine Rawnsley (Vp Revenue Cycle)
- NPI
- 1174484216
- Provider Name
- LIFESPAN PHYSICIAN GROUP, INC.
- Entity Type
- Organization
- Location Address
- 2 DUDLEY ST STE 470 PROVIDENCE, RI 02905
- Location Phone
- (401) 272-1800
- Location Fax
- (401) 751-5124
- Mailing Address
- 15 LA SALLE SQ PROVIDENCE, RI 02903
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-19-2025
- Last Update Date
- 12-02-2025
- Code Navigator
A surgeon like Lifespan Physician Group, Inc. treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.
Location Map
Secondary Locations
- 2 DUDLEY ST STE 190
Providence, RI 02905
(401) 272-1800 - 900 WARREN AVE STE 202
EAST PROVIDENCE, RI 02914
(401) 272-1800 - 1407 S COUNTY TRL STE 423
EAST GREENWICH, RI 02818
(401) 228-0590 - 195 COLLYER ST STE 302
Providence, RI 02904
(401) 793-3236 - 19 FRIENDSHIP ST UNIT 240
Newport, RI 02840
(401) 619-3930 - 2 Wake Robin Rd Ste 205
Lincoln, RI 02865
(401) 272-1800 - 639 METACOM AVE
WARREN, RI 02885
(401) 272-1800 - 1524 ATWOOD AVE
JOHNSTON, RI 02919
(401) 272-1800 - 593 EDDY ST APC 4
Providence, RI 02903
(401) 272-1800 - 208 COLLYER ST STE 301A
Providence, RI 02904
(401) 725-4888 - 164 SUMMIT AVE # C70
Providence, RI 02906
(401) 793-4545 - 1500 PONTIAC AVE
Cranston, RI 02920
(401) 272-1800 - 2 DUDLEY ST STE 370
Providence, RI 02905
(401) 272-1800 - 450 VETERANS MEMORIAL PKWY BLDG 9
EAST PROVIDENCE, RI 02914
(401) 272-1800 - 562 WASHINGTON ST
SOUTH ATTLEBORO, MA 02703
(401) 272-1800 - 100 HIGHLAND AVE STE 308
Providence, RI 02906
(401) 272-1800
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery
- Taxonomy Code
- 208600000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 41D2041521
- Facility Type
- Physician Office
- Certificate Effective Date
- February 25, 2026
- Certificate Expiration Date
- February 24, 2028
- Laboratory Director
- ANNMARIE JURCZAK MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Lifespan Physician Group, Inc. in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174484216, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PROVIDENCE, RI 02905
PROVIDENCE, RI 02905
PROVIDENCE, RI 02905
PROVIDENCE, RI 02905
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174484216, enumerated as an "organization" on November 19, 2025.
The provider is located at 2 DUDLEY ST STE 470 PROVIDENCE, RI 02905 and the phone number is (401) 272-1800.
Surgery with taxonomy code 208600000X.
