PROTESTANT MEMORIAL MEDICAL CENTER,INC (NPI# 1477633766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477633766 |
| Entity Type | Organization |
| Organization Name | PROTESTANT MEMORIAL MEDICAL CENTER,INC |
| Other Organization Name | MEMORIAL HOSPITAL |
| Practice Address |
4500 Memorial Dr Belleville IL 62226-5360 |
| Practice Telephone | 6182337750 |
| Mailing Telephone | 6182337750 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2013-02-19 |
| Authorized Official Name | MR. JOE H LANIUS (VICE PRESIDENT, FINANCE) |
| Authorized Official Telephone | 6182575648 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 0001461 | IL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD | 0008219585 | 01 |
| Other Name | Type Code |
|---|---|
| MEMORIAL HOSPITAL | Doing Business As Name - Organization |
| Street Address |
4500 MEMORIAL DR |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045568 | Kenneth I Bluestone | Anesthesiology | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2005-07-01 |
| 1558979690 | Protestant Memorial Medical Center, Inc. | Clinical Medical Laboratory | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-07-15 |
| 1841815784 | Kayla Marie Tisza | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-16 |
| 1588289581 | Katie O'rourke | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-15 |
| 1518592203 | Daniela Vetan-zlibut | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-03-03 |
| 1396377289 | Kathryn Cook | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-02-07 |
| 1124650353 | Jessica Stricklin | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5399 | 2020-02-05 |
| 1396375788 | Emily Jean Sloan | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-01-24 |
| 1629639695 | Nicholas Raburn | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-06-21 |
| 1124582523 | Jenna Dornak | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| 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 |
|---|---|---|---|---|
| 1497143440 | St Michael's Medical Center | General Acute Care Hospital | 110 Newark Ave Apt F6, Belleville, NJ 07109-4129 | 2014-12-29 |
| 1053603936 | St. Elizabeth's Hospital Sisters of The Third Order of St Francis | General Acute Care Hospital | 211 South Third Street, Belleville, IL 62220-1915 | 2011-05-10 |
| 1427176395 | Oscar Raynomd Gain Jr. | General Acute Care Hospital | 1105 Forest Hill Dr, Belleville, IL 62221-4008 | 2007-03-27 |
| 1962886366 | Andrea Grasso Irvine | General Acute Care Hospital | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2015-07-15 |
| 1730370560 | St. Elizabeth's Hospital | General Acute Care Hospital | 211 S 3rd St, Belleville, IL 62220-1915 | 2007-08-07 |
| 1407067978 | Saint Elizabeth's Hospital | General Acute Care Hospital | 211 S 3rd St, Belleville, IL 62220-1915 | 2007-05-25 |
| 1982796181 | Protestant Memorial Medical Center,inc. | General Acute Care Hospital | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2006-09-28 |
| 1902901333 | Clara Maass Medical Center | General Acute Care Hospital | 1 Clara Maass Dr, Reimbursement Department, Belleville, NJ 07109-3550 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619442266 | Pipeline-west Suburban Medical Center, LLC | General Acute Care Hospital | West Suburban Medical Center, 3 Erie Court, Oak Park, IL 60302-2519 | 2018-10-10 |
| 1093241275 | Northwest Community Hospital | General Acute Care Hospital | 2704 Royal Saint Georges Ct, Saint Charles, IL 60174-8754 | 2017-05-05 |
| 1831620632 | Macneal Hospital | General Acute Care Hospital | 665 Grove Dr Apt 112, Buffalo Grove, IL 60089-4038 | 2017-03-23 |
| 1801337506 | University of Chicago Medical Center | General Acute Care Hospital | 1122 Paysphere Cir, Chicago, IL 60674-0011 | 2017-03-14 |
| 1861935181 | Sarah Landon | General Acute Care Hospital | 6407 Martin St, Crystal Lake, IL 60014-4959 | 2016-11-19 |
| 1942750831 | Advocate Good Samaritan | General Acute Care Hospital | 4427 Woodward Ave, Downers Grove, IL 60515 | 2016-10-04 |
| 1063960870 | Mid America Emergency Medicine | General Acute Care Hospital | 700 N First St, Springfield, IL 62781-0001 | 2016-09-21 |
| 1336598937 | Daniel Benjamin Holt Jr. | General Acute Care Hospital | 2448 N Seminary Ave, Apt 2b, Chicago, IL 60614-7445 | 2016-06-06 |
| 1841650942 | Latoyia Roman | General Acute Care Hospital | 6756 S Oglesby Ave, Unit 1, Chicago, IL 60649-1316 | 2016-03-02 |
| 1306203583 | Rush University Medical Center | General Acute Care Hospital | 4536 N Greenview Ave Apt 2n, Chicago, IL 60640-5475 | 2016-01-19 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.