MASSAC MEMORIAL HOSPITAL (NPI# 1417303181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417303181 |
| Entity Type | Organization |
| Organization Name | MASSAC MEMORIAL HOSPITAL |
| Other Organization Name | MASSAC MEMORIAL FAMILY CARE CLINIC |
| Practice Address |
28 Chick St Ste 100 Metropolis IL 62960-2467 |
| Mailing Address |
Po Box 850 Metropolis IL 62960-0850 |
| Practice Telephone | 6186381343 |
| Practice Fax Number | 6186381340 |
| Mailing Telephone | 6185242176 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2019-07-11 |
| Authorized Official Name | MRS. LYNN GOINES (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6185242176 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
Ambulatory Health Care Facilities | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Massac Memorial Family Care Clinic | Doing Business As Name - Organization |
| MMH Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740355809 | Massac Memorial Hospital | Clinic/Center | 1204 W 10th St, Metropolis, IL 62960-0790 | 2006-11-22 |
| 1790788578 | Massac Memorial Hospital | General Acute Care Hospital | 28 Chick St, Metropolis, IL 62960-2467 | 2005-05-24 |
| 1356968275 | Massac Memorial Hospital | Clinic/Center | 510 W 10th St, Metropolis, IL 62960-1562 | 2020-06-26 |
| 1831226901 | Massac Memorial Hospital | Medicare Defined Swing Bed Unit | 28 Chick St, Metropolis, IL 62960-2467 | 2007-02-27 |
| 1801941968 | Massac Memorial Hospital | Ambulance | 28 Chick St, Metropolis, IL 62960-2467 | 2007-01-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MASSAC MEMORIAL HOSPITAL | 28 Chick St, Metropolis, IL 62960-2467 |
| Street Address |
28 CHICK ST STE 100 |
| City | METROPOLIS |
| State | IL |
| Zip Code | 62960-2467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427286038 | Jonathan E Walters | Family Medicine | 28 Chick St Ste 100, Metropolis, IL 62960-2467 | 2009-06-23 |
| 1043663917 | John Larrison | Nurse Practitioner | 28 Chick St Ste 100, Metropolis, IL 62960-2467 | 2016-07-15 |
| 1174813240 | Dena Lynn Kommer | Specialist | 28 Chick St Ste 100, Metropolis, IL 62960-2467 | 2011-04-11 |
| 1174827133 | Melanie Susan Chapman | Nurse Practitioner | 28 Chick St Ste 100, Metropolis, IL 62960-2467 | 2011-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972069078 | Amber Nicole Garcia | Social Worker | 205 W 5th Street, Metropolis, IL 62960 | 2019-02-13 |
| 1407251622 | Massac County Surgery Center LLC | Clinic/Center | 1811 E 5th St, Metropolis, IL 62960 | 2014-10-30 |
| 1750535761 | Robert Hays Bryan | Dentist | 805 Market St., Metropolis, IL 62960 | 2008-11-05 |
| 1518144682 | Rebecca Louise Mcquage | Counselor | 206 West 5th St, Metropolis, IL 62960 | 2008-01-30 |
| 1154640902 | Syed S Kazmi | Family Medicine | 12 Hospital Drive, Metropolis, IL 62960 | 2007-04-20 |
| 1083736680 | Bharat K Patel Sc | Internal Medicine | 12 Hospital Dr., Memorial Heights, Metropolis, IL 62960 | 2007-04-04 |
| 1467594747 | Peggy Sue Legereit | Speech-Language Pathologist | 3037 Lakeview Dr, Metropolis, IL 62960 | 2007-02-13 |
| 1821150475 | Ruth E Johnson | Counselor | 206 West 5th, Metropolis, IL 62960 | 2006-12-13 |
| 1720140379 | James Allen Haley | Counselor | 206 West 5th Street, Metropolis, IL 62960 | 2006-12-13 |
| 1659432185 | Gary T Brush | Optometrist | 1801 E 5th Street, Metropolis, IL 62960 | 2006-12-12 |
| Find all providers in zip 62960 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740355809 | Massac Memorial Hospital | Clinic/Center | 1204 W 10th St, Metropolis, IL 62960-0790 | 2006-11-22 |
| 1144432501 | Comprehensive Health Center Ltd | Clinic/Center | 1204 W 10th St, Metropolis, IL 62960-2433 | 2007-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396386181 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak St Ste 100, Carbondale, IL 62901-1496 | 2019-10-02 |
| 1043872781 | Mendota Community Hospital | Clinic/Center | 1401 E 12th St Ste 400, Mendota, IL 61342-9216 | 2019-07-02 |
| 1114582913 | Hammond Henry Dist Hospital | Clinic/Center | 203 W Front St, Annawan, IL 61234-7756 | 2019-05-07 |
| 1841763810 | Heartland Women's Healthcare Ltd | Clinic/Center | 24 Veterans Dr, Harrisburg, IL 62946-3320 | 2019-01-02 |
| 1821561895 | Heartland Women's Healthcare Ltd | Clinic/Center | 215 N Logan St Ste A, West Frankfort, IL 62896-2314 | 2019-01-02 |
| 1578040275 | Osf Healthcare System | Clinic/Center | 230 S Exchange St, Galva, IL 61434-1871 | 2018-07-25 |
| 1700380219 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1510 W Springfield Rd Ste A, Taylorville, IL 62568-2764 | 2018-03-20 |
| 1326542903 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1001 Avenue of Mid America Ste 4, Effingham, IL 62401-4634 | 2018-03-20 |
| 1649795659 | Harrisburg Medical Center Inc | Clinic/Center | 3106 Outer Dr Ste 200, Marion, IL 62959-5270 | 2017-08-10 |
| 1588186308 | Wabash General Hospital District | Clinic/Center | 1430 College Dr Ste A, Mount Carmel, IL 62863-2649 | 2017-07-13 |
| Find all providers with the same taxonomy | ||||
| City | METROPOLIS |
| Zip Code | 62960 |
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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.