MEMORIAL HOSPITAL (NPI# 1376759563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376759563 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL |
| Other Organization Name | KNOTT COUNTY FAMILY HEALTHCARE WEST |
| Practice Address |
86 Savannah Lane Bulan KY 41722 |
| Mailing Address |
509 Memorial Dr Manchester KY 40962-6195 |
| Practice Telephone | 6065985104 |
| Practice Fax Number | 6065980983 |
| Mailing Telephone | 6065985104 |
| Mailing Fax Number | 6065980983 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BENNY NOLEN (VICE PRESIDENT) |
| Authorized Official Telephone | 6065985104 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | APPLIED | APPLIED | 01 |
| Other Name | Type Code |
|---|---|
| Knott County Family Healthcare West | Doing Business As Name - 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 |
| 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 |
| 1477548774 | Memorial Hospital | General Acute Care Hospital | 1785 4th Ave, York, PA 17403-2615 | 2005-09-13 |
| 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 |
86 SAVANNAH LANE |
| City | BULAN |
| State | KY |
| Zip Code | 41722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588896260 | Jakes Branch Fire and Rescue | Emergency Medical Technician, Paramedic | 5447 Ky Hwy 476, Bulan, KY 41722-0065 | 2009-08-14 |
| 1437772738 | Key Recovery Solutions, LLC | Nurse Practitioner | 6487 Ky Highway 476, Bulan, KY 41722-8717 | 2020-05-20 |
| 1306878996 | Mountain Mobile Diagnostics, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 725 Hardburly Rd, Bulan, KY 41722-8907 | 2006-07-06 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890431 | Alishia Gayle Euler | Family Medicine | 730 Della Dr, Lexington, KY 40504-3610 | 2020-11-01 |
| 1306443908 | Complete Wellness Inc | Family Medicine | 25 Joshua Lane, Hawesville, KY 42348 | 2020-10-06 |
| 1811503410 | Angela Coffman | Family Medicine | 1000 Thompson Dr, Beaver Dam, KY 42320-9152 | 2020-09-18 |
| 1871107375 | West Towne Clinical Services Pllc | Family Medicine | 2755 W Park Dr Ste 1, Paducah, KY 42001-9058 | 2020-09-02 |
| 1528670981 | Visium Healthlink LLC | Family Medicine | 507 Avawam Dr, Richmond, KY 40475-9195 | 2020-08-18 |
| 1114535911 | Lea Anne Bunch | Family Medicine | 12080 S Dixie Hwy, Sonora, KY 42776-9739 | 2020-07-17 |
| 1952929689 | Yasir LLC | Family Medicine | 103 Financial Pl Ste 300, Elizabethtown, KY 42701-4470 | 2020-07-09 |
| 1578188637 | Megan Elizabeth Burke | Family Medicine | 641 Zag Rd, West Liberty, KY 41472-7625 | 2020-06-14 |
| 1679197529 | Kentucky Mountain Interventional and Infusion Therapies, LLC. | Family Medicine | 101 Hibbard St Ste 200, Pikeville, KY 41501-1788 | 2020-06-05 |
| 1548883960 | Proactive Md Ky Psc | Family Medicine | 4340 Crittenden Dr, Louisville, KY 40209-1600 | 2020-05-20 |
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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.