COMMUNITY MEMORIAL HOSPITAL (NPI# 1417021288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417021288 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEMORIAL HOSPITAL |
| Practice Address |
1755 N Mecklenburg Avenue South Hill VA 23970-1431 |
| Mailing Address |
Po Box 90 South Hill VA 23970-0090 |
| Practice Telephone | 4344473151 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2018-01-30 |
| Authorized Official Name | MR. KENNETH LIBBY JR. (VP OF FINANCE, CFO) |
| Authorized Official Telephone | 4345845410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM SWING | 000055 | 01 | |
| VA | 004900987 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336632280 | Community Memorial Hospital | Clinic/Center | 104 S. West Street, Edgerton, OH 43517 | 2018-06-14 |
| 1528208162 | Community Memorial Hospital | Family Medicine | 100 West 4th St, Montrose, MO 64770 | 2009-02-23 |
| 1689842478 | Community Memorial Hospital | Clinic/Center | 122 2nd St. East, Mcclusky, ND 58463-0618 | 2008-02-14 |
| 1598945867 | Community Memorial Hospital | Clinic/Center | 101 Giesler Dr, Osceola, MO 64776-6297 | 2007-11-05 |
| 1730145392 | Community Memorial Hospital | Clinic/Center | 208 Columbus Street, Hicksville, OH 43526 | 2006-04-24 |
| 1336103738 | Community Memorial Hospital | General Acute Care Hospital | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-04-13 |
| 1780150110 | Community Memorial Hospital | Clinic/Center | 107 Buffalo St, Antwerp, OH 45813-8434 | 2018-10-24 |
| 1164915021 | Community Memorial Hospital | Clinic/Center | 208 Columbus St, Hicksville, OH 43526-1250 | 2018-06-14 |
| 1891288866 | Community Memorial Hospital | Clinic/Center | 422 W River St, Antwerp, OH 45813-8417 | 2018-06-13 |
| 1609303692 | Community Memorial Hospital | Family Medicine | 164 Broad St, Hamilton, NY 13346-9575 | 2017-05-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL | 809 Jackson St, Burke, SD 57523-2065 |
| Virginia Business Entities | Community Memorial Hospital | 1755 N Mecklenburg Ave, P. O. Box 90, South Hill, Virginia 23970-4080 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL ASSOCIATION | 400 Caldwell St, Staunton, IL 62088-1173 |
| Virginia Business Entities | Community Memorial Hospital Foundation | 1755 N Mecklenburg Ave, South Hill, Virginia 23970-4080 |
| New York State Corporations | COMMUNITY MEMORIAL HOSPITAL FOUNDATION, INC. | 150 Broad St., Hamilton, Ny 13346 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INC. | 2731 Healthcare Dr, Syracuse, NE 68446-7880 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INCORPORATED | 800 Memorial Dr Ste 1, Spring Valley, MN 55975-1055 |
| Street Address |
1755 N MECKLENBURG AVENUE |
| City | SOUTH HILL |
| State | VA |
| Zip Code | 23970-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336103738 | Community Memorial Hospital | General Acute Care Hospital | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-04-13 |
| 1891014015 | Community Memorial Hospital | Hospitalist | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2010-05-27 |
| 1669551545 | Community Memorial Hospital | Home Health | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-11-03 |
| 1184709586 | Community Memorial Hospital | Hospice Care, Community Based | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043784606 | Elizabeth Jene Ezell | Dental Hygienist | 604 N. Thomas St., South Hill, VA 23970 | 2019-01-17 |
| 1821576901 | Mackenzie Jean Blackwell | Dental Hygienist | 604 N. Thomas St, South Hill, VA 23970 | 2018-08-01 |
| 1316459357 | Bernita Danica Boyd | Contractor | 436 Theater Rd, South Hill, VA 23970 | 2017-10-31 |
| 1194242909 | More Transport LLC | Non-emergency Medical Transport (VAN) | 651 Clearview Dr, South Hill, VA 23970 | 2017-08-23 |
| 1912423534 | Larry D Warren | Driver | 730 Hite Street, Po Box 896, South Hill, VA 23970 | 2017-08-15 |
| 1902320658 | Lakika Lyshon Hicks | Non-emergency Medical Transport (VAN) | 74 Hudgins Road, South Hill, VA 23970 | 2017-08-02 |
| 1053835561 | Vernice Luevine Lewis | Driver | 11525 Highway One, South Hill, VA 23970 | 2017-07-27 |
| 1407376924 | Building Blocks To Success LLC | Occupational Therapist | 20429 Hwy Forty-seven, South Hill, VA 23970 | 2017-06-26 |
| 1316477136 | Eric Blackwell | Driver | 248 Circle Dr, South Hill, VA 23970 | 2017-06-14 |
| 1619341443 | North View Day Support LLC | Day Training, Developmentally Disabled Services | 359 Saffold Road, South Hill, VA 23970 | 2015-11-17 |
| Find all providers in zip 23970 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780813881 | Columbia-alleghany Regional Hospital Inc | Medicare Defined Swing Bed Unit | 1 Alleghany Reg Hospital Ln, Low Moor, VA 24457 | 2009-07-09 |
| 1174564389 | Pennington Gap Hma Inc | Medicare Defined Swing Bed Unit | West Morgan Avenue, Pennington Gap, VA 24277 | 2006-06-09 |
| 1205807690 | Emporia Hospital Corporation | Medicare Defined Swing Bed Unit | 727 N Main St, Emporia, VA 23847-1274 | 2006-02-01 |
| 1295370328 | Bon Secours Mercy Health Franklin LLC | Medicare Defined Swing Bed Unit | 100 Fairview Dr, Franklin, VA 23851-1238 | 2019-11-13 |
| 1194360263 | Bon Secours Mercy Health Emporia LLC | Medicare Defined Swing Bed Unit | 727 N Main St, Emporia, VA 23847-1274 | 2019-11-13 |
| 1609226539 | Chesapeake Hospital LLC | Medicare Defined Swing Bed Unit | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2016-06-22 |
| 1023459252 | Valerie Vanessa Hatcher | Medicare Defined Swing Bed Unit | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2013-07-16 |
| 1679847503 | Dlp Twin County Regional Healthcare LLC | Medicare Defined Swing Bed Unit | 200 Hospital Dr, Galax, VA 24333-2227 | 2012-02-23 |
| 1831412030 | Clinch Valley Medical Center, Inc. | Medicare Defined Swing Bed Unit | 6801 Governor Gc Peery Hwy, Richlands, VA 24641-2194 | 2010-03-03 |
| 1346477379 | Carilion Tazewell Community Hospital | Medicare Defined Swing Bed Unit | 141 Ben Bolt Ave, Tazewell, VA 24651-9700 | 2009-06-17 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HILL |
| Zip Code | 23970 |
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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.