MEMORIAL MEDICAL CENTER (NPI# 1538379581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538379581 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER |
| Practice Address |
701 N 1st St Springfield IL 62702-3757 |
| Mailing Address |
505 Hartford Dr Sherman IL 62684-9627 |
| Practice Telephone | 2177883000 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHELE KLODT (REGISTERED NURSE, STAFF) |
| Authorized Official Telephone | 2177883000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | IL | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719836 | Memorial Medical Center | Nursing Care | 118 Trinity Shores Drive, Port Lavaca, TX 77979 | 2019-09-18 |
| 1497153589 | Memorial Medical Center | Family Medicine | 1016 N. Virginia St., Port Lavaca, TX 77979-0000 | 2014-12-05 |
| 1588075964 | Memorial Medical Center | Skilled Nursing Facility | 2100 Dove Crossing Ln, Navasota, TX 77868-5247 | 2014-05-19 |
| 1275717894 | Memorial Medical Center | Skilled Nursing Facility | 2750 Miller Ranch Rd, Pearland, TX 77584-9763 | 2007-12-18 |
| 1679549968 | Memorial Medical Center | Audiologist | 644 North Second Street, Springfield, IL 62781-0001 | 2006-02-27 |
| 1124099098 | Memorial Medical Center | General Acute Care Hospital | 701 N !st St, Mab 528, Springfield, IL 62781-0001 | 2006-01-30 |
| 1922092790 | Memorial Medical Center | Skilled Nursing Facility | 1008 Enterprise Blvd, Rockport, TX 78382-3201 | 2005-09-07 |
| 1568017481 | Memorial Medical Center | Clinic/Center | 701 N 1st St, Springfield, IL 62781-0001 | 2019-08-07 |
| 1053964742 | Memorial Medical Center | Orthopaedic Surgery | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2019-07-22 |
| 1164954806 | Memorial Medical Center | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-03-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER | 8260 Atlee Rd Ste 1203, Mechanicsville, VA 23116-1844 |
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER INC | 1615 Maple Ln, Ashland, WI 54806-3610 |
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER OF EAST TEXAS | 1201 W Frank Ave, Lufkin, TX 75904-3357 |
| Street Address |
701 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607123 | Memorial Home Services | Home Health | 701 N 1st St, Springfield, IL 62781-4952 | 2005-05-23 |
| 1316552524 | Mary Ann Seagle | Nurse Practitioner | 701 N 1st St, Springfield, IL 62781-0001 | 2020-09-14 |
| 1497372361 | Amir Mcphearson | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-26 |
| 1508482597 | Kirsten Kay Carew | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-25 |
| 1699391482 | Aruya Davis | Registered Nurse | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-17 |
| 1497370852 | Alyssa Rose Jimerson | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-11 |
| 1649895038 | Elisha Boyd | Nurse Practitioner | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-10 |
| 1275158990 | Ashley L Mcgrath | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-09 |
| 1205451812 | Christopher Evan Bejcek | Orthopaedic Surgery | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-09 |
| 1912521790 | Neil Carter Parker | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740463074 | St. Joseph's Home of Springfield | Nursing Facility/Intermediate Care Facility | 3306 S 6th Street Rd, Springfield, IL 62703-4735 | 2007-12-10 |
| 1659497774 | Oak Terrace Healthcare Center, Inc. | Nursing Facility/Intermediate Care Facility | 1750 W Washington St, Springfield, IL 62702-4759 | 2007-03-21 |
| 1750468237 | Springfield Health Care Operating Company, LLC | Nursing Facility/Intermediate Care Facility | 404 E. Mccreight Ave., Springfield, OH 45503 | 2006-11-01 |
| 1932183134 | Christian Care Center of Springfield LLC | Nursing Facility/Intermediate Care Facility | 704 5th Ave E, Springfield, TN 37172-2604 | 2005-12-01 |
| 1053302695 | Southeast Colorado Hospital District | Nursing Facility/Intermediate Care Facility | 373 East 10th Avenue, Springfield, CO 81073-1622 | 2005-11-02 |
| 1902804305 | Springfield Terrace, Ltd | Nursing Facility/Intermediate Care Facility | 525 S Martin Luther King Jr Dr, Springfield, IL 62703-1317 | 2005-07-08 |
| 1114272374 | Select Rehab | Nursing Facility/Intermediate Care Facility | 1707 W Elfindale St, Springfield, MO 65807-1246 | 2012-07-13 |
| 1053627448 | Springfield Care Center, LLC | Nursing Facility/Intermediate Care Facility | 525 S Martin Luther King Jr Dr, Springfield, IL 62703-1317 | 2010-08-24 |
| 1598905838 | Springfield Healthcare Group Inc | Nursing Facility/Intermediate Care Facility | 404 E Mccreight Ave, Springfield, OH 45503-3653 | 2009-02-26 |
| 1245447762 | Nancy M Paquette | Nursing Facility/Intermediate Care Facility | 136 William St, Springfield, MA 01105-2324 | 2007-05-16 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.