MEMORIAL HEALTHCARE GROUP INC (NPI# 1174560254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174560254 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HEALTHCARE GROUP INC |
| Other Organization Name | MEMORIAL HOSPITAL JACKSONVILLE |
| Practice Address |
3625 University Blvd S Jacksonville FL 32216-4207 |
| Mailing Address |
Po Box 16325 Jacksonville FL 32245-6325 |
| Practice Telephone | 9043996111 |
| Practice Fax Number | 9043996849 |
| Mailing Telephone | 9043996111 |
| Mailing Fax Number | 9043996849 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2008-09-29 |
| Authorized Official Name | ASHLEY JOHNSON (CFO) |
| Authorized Official Telephone | 9043911172 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1211862 | 05 |
| Other Name | Type Code |
|---|---|
| MEMORIAL HOSPITAL JACKSONVILLE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083997779 | Memorial Healthcare Group Inc | Psychiatric Unit | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2011-09-20 |
| 1447206438 | Memorial Healthcare Group Inc | General Acute Care Hospital | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2006-05-25 |
| Street Address |
3625 UNIVERSITY BLVD S |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-4207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664395 | Karen Elizabeth Anderson | Anesthesiology | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2005-07-22 |
| 1174122071 | Deleah Rene Pickler | Registered Nurse | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2020-10-21 |
| 1801401641 | Kara N Cordova | Nurse Anesthetist, Certified Registered | 3625 University Blvd S, Jacksonville, FL 32216-4222 | 2020-09-09 |
| 1174153654 | Marina Follick | Registered Nurse | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2020-01-23 |
| 1649818337 | Sarah Chapman Farris | Registered Nurse | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2019-12-13 |
| 1487291837 | Lee Willingham | Registered Nurse | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2019-12-04 |
| 1609411586 | Kyle Steven Scott | Nurse Anesthetist, Certified Registered | 3625 University Blvd S, Jacksonville, FL 32216-4222 | 2019-11-14 |
| 1982246328 | Amy Marie Suralis | Registered Nurse | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2019-10-16 |
| 1396391991 | Sarah Siebrandt | Occupational Therapist | 3625 University Blvd S, Jacksonville, FL 32216-4222 | 2019-08-11 |
| 1790347979 | Leda Hansen | Nurse Practitioner | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2019-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| 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 |
|---|---|---|---|---|
| 1528683257 | Gainesville Vamc | General Acute Care Hospital | 2080 Child St Bldg 200h, Jacksonville, FL 32214-5005 | 2020-06-09 |
| 1922487974 | Shemaka James | General Acute Care Hospital | 5202 Wabash Blvd, Jacksonville, FL 32254-1366 | 2015-05-22 |
| 1962893149 | Michelle Porter | General Acute Care Hospital | 402 Stagecoach Dr, Jacksonville, NC 28546-8663 | 2015-02-10 |
| 1811246390 | St. Vincent's Healthcare | General Acute Care Hospital | 3 Shircliff Way Ste 714, Jacksonville, FL 32204-4786 | 2012-08-30 |
| 1255570974 | Svila Skin Solutions | General Acute Care Hospital | 1936 San Marco Blvd, Jacksonville, FL 32207-3286 | 2009-02-19 |
| 1760644009 | Walter Ruday Jr. | General Acute Care Hospital | 2748 University Blvd W, Jacksonville, FL 32217-2123 | 2008-06-27 |
| 1386801116 | Abdolreza Mohammadian | General Acute Care Hospital | 1536 N.jefferson Street, Va Outpatient Clinic, Jacksonville, FL 32209-0000 | 2008-05-20 |
| 1861451114 | Allegiance Hospital of North Little Rock, LLC | General Acute Care Hospital | 1400 Braden St., Jacksonville, AR 72076 | 2006-03-23 |
| 1730697350 | Jacksonville Hospital LLC | General Acute Care Hospital | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2018-01-17 |
| 1144735069 | Brynn Marr Hospital - Navy Resource Sharing | General Acute Care Hospital | 192 Village Dr, Jacksonville, NC 28546-7238 | 2017-12-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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| 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.