MEMORIAL HOSPITAL (NPI# 1346305638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346305638 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL |
| Other Organization Name | MEMORIAL HOSPITAL OF CARBONDALE |
| Practice Address |
305 W Jackson St Carbondale IL 62901-1474 |
| Mailing Address |
1706 W Josephine Ln Marion IL 62959-1564 |
| Practice Telephone | 6185490721 |
| Mailing Telephone | 6189936963 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JEFFREY RICHARD FOX (PHYSICAL THERAPIST) |
| Authorized Official Telephone | 6185490721 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283X00000X | Rehabilitation Hospital | IL | Hospitals |
| Other Name | Type Code |
|---|---|
| Memorial Hospital of Carbondale | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528447992 | Memorial Hospital | General Acute Care Hospital | 1400 E. Boulder St. #3138, Colorado Springs, CO 80045 | 2015-05-19 |
| 1629469002 | Memorial Hospital | Family Medicine | 2319 Old Plank Road, Chester, IL 62233-1116 | 2015-02-06 |
| 1609073709 | Memorial Hospital | Nurse Practitioner | 9099 E Lansing Rd Ste B, Durand, MI 48429-1083 | 2007-07-02 |
| 1003025883 | Memorial Hospital | Psychiatric Residential Treatment Facility | 806 Central Ave Se, Albuquerque, NM 87102-3606 | 2007-05-21 |
| 1376759563 | Memorial Hospital | Family Medicine | 86 Savannah Lane, Bulan, KY 41722 | 2007-05-15 |
| 1598977787 | Memorial Hospital | Family Medicine | 3337 W Britton Rd, Perry, MI 48872 | 2007-05-03 |
| 1639209232 | Memorial Hospital | Internal Medicine | 1480 N M 52, Owosso, MI 48867-1235 | 2007-03-06 |
| 1306973805 | Memorial Hospital | Physician Assistant | 207 Shirlwood Dr, Schenectady, NY 12306-3417 | 2007-02-28 |
| 1851338149 | Memorial Hospital | General Acute Care Hospital | 715 South Taft Avenue, Fremont, OH 43420-3200 | 2006-06-02 |
| 1316923485 | Memorial Hospital | Hospice Care, Community Based | 1412 6th Ave, York, PA 17403-2648 | 2005-12-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL | 224 E 2nd St, Dumas, TX 79029-3808 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL & HEALTH CARE CENTER | 800 W 9th St, Jasper, IN 47546-2514 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND COMMUNITY HEALTH FOUNDATION INC | 112 East Fifth Avenue, Antigo, WI 54409-2710 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND HOMES ASSOCIATION, INC. | 415 8th Ave Sw, Perham, MN 56573-1156 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MANOR | 1500 E Shotwell St, Bainbridge, GA 39819-4256 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MEDICAL CENTER | 400 Rosalind Redfern Grover Parkway, Midland, TX 79701-5846 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AT GULFPORT | 4500 13th St, Gulfport, MS 39501-2515 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL CENTRAL | 1400 E Boulder St, Colorado Springs, CO 80909-5533 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL EAST | 1404 Cross St, Shiloh, IL 62269-2988 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL FOR CANCER & ALLIED DISEASES | 1275 York Ave, New York, NY 10065-6007 |
| Street Address |
305 W JACKSON ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596726 | John Ward Watson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 305 W Jackson St, Suite 105, Carbondale, IL 62901-1474 | 2005-05-24 |
| 1780034926 | Ahmed Sharif | Family Medicine | 305 W Jackson St, Carbondale, IL 62901-1474 | 2016-06-19 |
| 1548619406 | Jordan Wood | Family Medicine | 305 W Jackson St, Carbondale, IL 62901-1474 | 2016-06-10 |
| 1225499825 | Ashley Nicole Freeman | Nurse Practitioner | 305 W Jackson St, Ste 103, Carbondale, IL 62901 | 2016-03-10 |
| 1548625460 | Kasia Schaefer | Physical Medicine & Rehabilitation | 305 W Jackson St, Carbondale, IL 62901-1474 | 2015-12-18 |
| 1770966137 | Pamela Renee Milano | Family Medicine | 305 W Jackson St, Ste 200, Carbondale, IL 62901-1474 | 2015-07-02 |
| 1215319140 | Gritz Pierre | Family Medicine | 305 W Jackson St, 200, Carbondale, IL 62901-1474 | 2015-06-27 |
| 1154702116 | Nabeel Mohammed Siddiqui | Family Medicine | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2015-06-16 |
| 1992196752 | New Horizons Medical Associates, LLC | Obstetrics & Gynecology | 305 W Jackson St, Suite 100, Carbondale, IL 62901-1474 | 2015-02-13 |
| 1255747002 | Fariha Rub | Family Medicine | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2014-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 283X00000X |
| Grouping | Hospitals |
| Classification | Rehabilitation Hospital |
| A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. |
| Notes: Source: Joint Commission on Accreditation of Healthcare Organizations, Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Oakbrook Terrace, IL: 1994, p. 323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356877567 | Michelle Wirth | Rehabilitation Hospital | 355 E Erie, Shirley Ryan Ability Lab, Chicago, IL 60611-2654 | 2017-05-08 |
| 1487108973 | Center for Comprehensive Services, Inc. | Rehabilitation Hospital | 1471 E Business Center Dr # D, Mount Prospect, IL 60056-6046 | 2016-08-12 |
| 1760815096 | Center for Comprehensive Services, Inc | Rehabilitation Hospital | 707 W Helen Rd, Palatine, IL 60067-6056 | 2013-08-09 |
| 1316387236 | Saint Johns Hospital | Rehabilitation Hospital | 141 E Maywood Street, Morton, IL 61550 | 2013-06-25 |
| 1619315751 | Brenna Elizabeth Hill | Rehabilitation Hospital | 6942 E 3500n Rd, Bourbonnais, IL 60914-4054 | 2013-06-11 |
| 1154669646 | Center for Comprehensive Services, Inc. | Rehabilitation Hospital | 1158 N Deer Ave, Palatine, IL 60067-1809 | 2013-01-18 |
| 1720330343 | Center for Comprehensive Services, Inc. | Rehabilitation Hospital | 820 Berkshire Ln, Des Plaines, IL 60016-7541 | 2012-10-05 |
| 1831410372 | Northshore University Health Care Systems | Rehabilitation Hospital | 790 Edgemere Rd, Buffalo Grove, IL 60089-8013 | 2010-06-18 |
| 1932438108 | Jesse Brown Va Medical Center | Rehabilitation Hospital | 215 W 59th St, Apt 17, Hinsdale, IL 60521-4973 | 2009-12-16 |
| 1912119041 | Rehabilitation Institute of Chicago | Rehabilitation Hospital | 345 E Superior Street, 7th Floor, Chicago, IL 60611 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.