MEMORIAL MEDICAL CENTER (NPI# 1164954806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164954806 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER |
| Other Organization Name | CARDIOLOGY PROFEES |
| Practice Address |
701 N 1st St Mailbox 95 Springfield IL 62781-0001 |
| Practice Telephone | 8005775368 |
| Practice Fax Number | 2177572021 |
| Mailing Telephone | 8005775368 |
| Mailing Fax Number | 2177572021 |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |
| Authorized Official Name | ROBERT KAY (VICE PRESIDENT/CFO) |
| Authorized Official Telephone | 2177883198 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Cardiology ProFees | Doing Business As Name - Organization |
| 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 |
| 1104203181 | Memorial Medical Center | Surgery | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2015-04-29 |
| 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 MAILBOX 95 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62781-0001 |
| 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 |
|---|---|---|---|---|
| 1104145747 | Justin Neil Henry | Hospitalist | 701 N 1st St Rm B146, Springfield, IL 62781 | 2010-05-21 |
| 1457464208 | Edward J Ryan Poje | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| 1649285453 | Sanjai Nagendra | Pathology | 701 N First Street, Springfield, IL 62781 | 2006-07-30 |
| 1770518706 | Daniel L Stanton Jr. | Radiology | 701 N. First St, Springfield, IL 62781 | 2006-07-11 |
| 1497914741 | Ted Robert Clark | Emergency Medicine | 701 N. 1st Street, Springfield, IL 62781 | 2008-06-03 |
| 1851486393 | Joan Lewis | Nurse Practitioner | 701 N First St, Springfield, IL 62781 | 2006-10-03 |
| 1548363138 | Pathology Associates of Central Illinois Ltd | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-09-07 |
| 1962511931 | Chad Joseph Defrain | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1346359320 | Nassim Banisaeed | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1922111772 | John E Murphy | Pathology | 701 N First Street, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| Find all providers in zip 62781 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366905523 | Premier Cardiac and Vascular LLC | Internal Medicine | 5514 Alma Ln Ste 200, Springfield, VA 22151-4014 | 2019-04-12 |
| 1760820930 | Shady Henien | Internal Medicine | 800 E Carpenter St # 62, Springfield, IL 62769-1000 | 2013-06-11 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1669784781 | Clifford Eugene Schott Jr. | Internal Medicine | 531 W Woodland Ave, Springfield, PA 19064-1646 | 2010-07-06 |
| 1730406760 | Joseph James Marmora | Internal Medicine | 211 Mountain Avenue, Associates In Cardiovascular Disease, Springfield, NJ 07081 | 2010-04-30 |
| 1083858310 | Brian Scott Wasserman | Internal Medicine | 3300 Main St Fl 2, Springfield, MA 01107-1112 | 2009-04-30 |
| 1104085505 | Sujata Holman | Internal Medicine | 2 Medical Center Dr Ste 410, Springfield, MA 01107-1273 | 2008-06-02 |
| 1932396157 | Centrum Cardiology, Ltd | Internal Medicine | 319 E Madison St Ste 2d, Springfield, IL 62701-3120 | 2007-10-02 |
| 1386858876 | Allen B. Weisse | Internal Medicine | 164 Hillside Ave, Springfield, NJ 07081-2808 | 2007-05-10 |
| 1467541433 | David S. Cochran | Internal Medicine | 2115 S Fremont Ave Ste 4300, Springfield, MO 65804-2232 | 2006-10-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62781 |
Please comment or provide details below to improve the information on MEMORIAL MEDICAL CENTER.
| 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.