FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION (NPI# 1053409615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053409615 |
| Entity Type | Organization |
| Organization Name | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION |
| Other Organization Name | FAIRFIELD MEMORIAL HOSPITAL HOME HEALTH AGENCY |
| Practice Address |
303 Nw 11th St Fairfield IL 62837-1203 |
| Practice Telephone | 6188478260 |
| Practice Fax Number | 6188478387 |
| Mailing Telephone | 6188478260 |
| Mailing Fax Number | 6188478387 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-02-22 |
| Authorized Official Name | MR. MICHAEL J BROWN (CFO) |
| Authorized Official Telephone | 6188478260 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 1007202 | IL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 9730 | 01 |
| Other Name | Type Code |
|---|---|
| FAIRFIELD MEMORIAL HOSPITAL HOME HEALTH AGENCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295908853 | Fairfield Memorial Hospital Association | Clinic/Center | 213 Nw 10th St, Suite A, Fairfield, IL 62837-1219 | 2008-04-03 |
| 1649442419 | Fairfield Memorial Hospital Association | Family Medicine | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2008-04-01 |
| 1407932601 | Fairfield Memorial Hospital Association | Skilled Nursing Facility | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2006-10-31 |
| 1255422416 | Fairfield Memorial Hospital Association | General Acute Care Hospital | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2006-09-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION | 303 Northwest 11th St, Fairfield, IL 62837-1203 |
| Street Address |
303 NW 11TH ST |
| City | FAIRFIELD |
| State | IL |
| Zip Code | 62837-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518910330 | Christopher D Beehn | Physical Therapist | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2006-05-19 |
| 1093345167 | Dana Shantel Taylor | Social Worker | 303 Nw 11th St, Fairfield, IL 62837-1206 | 2020-01-17 |
| 1962983338 | Sherrill Kay Funkhouser | Physician Assistant | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2018-08-23 |
| 1124494174 | Mary Lou Mcculley | Health Educator | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2015-08-13 |
| 1548657158 | Dylan Wayne Stennett | Nurse Practitioner | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2015-04-21 |
| 1063802916 | Whitney Elaine Buckles | Dietitian, Registered | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2015-01-30 |
| 1649442419 | Fairfield Memorial Hospital Association | Family Medicine | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2008-04-01 |
| 1295920387 | Total Renal Care Inc | Clinic/Center | 303 Nw 11th St, Ste 1, Fairfield, IL 62837-1203 | 2007-09-11 |
| 1790982650 | April Joy Best | Speech-Language Pathologist | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2007-07-02 |
| 1558418111 | Fairfield Memorial Hospital | Pharmacy | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2007-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294619 | Katelyn Atteberry | Pharmacist | 150 Commerce Drive, Fairfield, IL 62837 | 2020-10-30 |
| 1265894521 | Rebecca August | Social Worker | 506 Nw 9th St, Fairfield, IL 62837 | 2016-03-25 |
| 1063814259 | Kathie L Hill | Social Worker | 303 Nw 11th St., Fairfield Memorial Hospital, Fairfield, IL 62837 | 2014-09-19 |
| 1912206731 | Way-fair Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 305 Northwest 11th Street, Fairfield, IL 62837 | 2011-03-18 |
| 1063600773 | Alvin Ewing | Counselor | 407 N. Basin Road, Fairfield, IL 62837 | 2007-10-09 |
| 1417145129 | Gilbert Tennyson | Counselor | 407 North Basin Rd, Fairfield, IL 62837 | 2007-10-09 |
| 1972791689 | Clint Harvey | Counselor | 407 North Basin Road, Fairfield, IL 62837 | 2007-10-09 |
| 1770789778 | Fairfield Estates, LLC | Point of Service | 315 North Market Street, Fairfield, IL 62837 | 2007-06-26 |
| 1346382207 | Robert E Lowry | Counselor | 407 N Basin Rd., Fairfield, IL 62837 | 2007-02-13 |
| 1790840825 | Bradley D Kramer | Dentist | 301 Nw 11th Street, Suite 212, Fairfield, IL 62837 | 2006-12-27 |
| Find all providers in zip 62837 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494745 | Adrian's Wings Home Care LLC | Home Health | 5457 Southgate Blvd Apt 7, Fairfield, OH 45014-3448 | 2020-10-13 |
| 1770126963 | Seven Stars Home Care Services, LLC | Home Health | 1495 Black Rock Tpke Ste 2c, Fairfield, CT 06825-4165 | 2019-10-21 |
| 1932740933 | Healing Touch Home Care LLC | Home Health | 7225 Dixie Hwy Ste A, Fairfield, OH 45014-8503 | 2019-10-01 |
| 1235625690 | Alpha & Omega Healthcare LLC | Home Health | 3830 Woodridge Blvd Ste F, Fairfield, OH 45014-7564 | 2018-07-09 |
| 1376032540 | Total Home Healthcare Services LLC | Home Health | 526 Nilles Rd Ste 9, Fairfield, OH 45014-2624 | 2018-05-03 |
| 1629565122 | Ally Angel Care LLC | Home Health | 5128 Pleasant Ave, Fairfield, OH 45014-2611 | 2018-04-19 |
| 1457851636 | Eleos White LLC | Home Health | 1700 Post Rd Ste B3, Fairfield, CT 06824-5726 | 2018-02-14 |
| 1891206942 | Our Compassionate Hearts LLC | Home Health | 5380 Camelot Dr Apt 11, Fairfield, OH 45014-7451 | 2017-10-17 |
| 1760920607 | Faith Home Health Care LLC | Home Health | 271 Us Highway 46 Ste B201, Fairfield, NJ 07004-2430 | 2017-02-10 |
| 1104274166 | New Life Health Care LLC | Home Health | 3607 Woodridge Blvd Apt 9, Fairfield, OH 45014-7512 | 2016-06-01 |
| Find all providers in FAIRFIELD | ||||
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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.