COMMUNITY MEMORIAL HOSPITAL (NPI# 1578642450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578642450 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEMORIAL HOSPITAL |
| Practice Address |
125 Buena Vista Cir South Hill VA 23970-1431 |
| Mailing Address |
Po Box 90 South Hill VA 23970-0090 |
| Practice Telephone | 4344473151 |
| Mailing Telephone | 4345845410 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-01-30 |
| Authorized Official Name | MR. KENNETH LIBBY JR. (VP OF FINANCE/CFO) |
| Authorized Official Telephone | 4345845410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 004951778 | 05 | |
| ANTHEM BC | 245125 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336632280 | Community Memorial Hospital | Clinic/Center | 104 S. West Street, Edgerton, OH 43517 | 2018-06-14 |
| 1528208162 | Community Memorial Hospital | Family Medicine | 100 West 4th St, Montrose, MO 64770 | 2009-02-23 |
| 1689842478 | Community Memorial Hospital | Clinic/Center | 122 2nd St. East, Mcclusky, ND 58463-0618 | 2008-02-14 |
| 1598945867 | Community Memorial Hospital | Clinic/Center | 101 Giesler Dr, Osceola, MO 64776-6297 | 2007-11-05 |
| 1730145392 | Community Memorial Hospital | Clinic/Center | 208 Columbus Street, Hicksville, OH 43526 | 2006-04-24 |
| 1336103738 | Community Memorial Hospital | General Acute Care Hospital | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-04-13 |
| 1780150110 | Community Memorial Hospital | Clinic/Center | 107 Buffalo St, Antwerp, OH 45813-8434 | 2018-10-24 |
| 1164915021 | Community Memorial Hospital | Clinic/Center | 208 Columbus St, Hicksville, OH 43526-1250 | 2018-06-14 |
| 1891288866 | Community Memorial Hospital | Clinic/Center | 422 W River St, Antwerp, OH 45813-8417 | 2018-06-13 |
| 1609303692 | Community Memorial Hospital | Family Medicine | 164 Broad St, Hamilton, NY 13346-9575 | 2017-05-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL | 809 Jackson St, Burke, SD 57523-2065 |
| Virginia Business Entities | Community Memorial Hospital | 1755 N Mecklenburg Ave, P. O. Box 90, South Hill, Virginia 23970-4080 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL ASSOCIATION | 400 Caldwell St, Staunton, IL 62088-1173 |
| Virginia Business Entities | Community Memorial Hospital Foundation | 1755 N Mecklenburg Ave, South Hill, Virginia 23970-4080 |
| New York State Corporations | COMMUNITY MEMORIAL HOSPITAL FOUNDATION, INC. | 150 Broad St., Hamilton, Ny 13346 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INC. | 2731 Healthcare Dr, Syracuse, NE 68446-7880 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INCORPORATED | 800 Memorial Dr Ste 1, Spring Valley, MN 55975-1055 |
| Street Address |
125 BUENA VISTA CIR |
| City | SOUTH HILL |
| State | VA |
| Zip Code | 23970-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194706598 | David Hamilton Brown | Emergency Medicine | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2005-11-11 |
| 1477186088 | Megan Puckett | Occupational Therapist | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2020-02-21 |
| 1548807308 | Teresa Morgan | Occupational Therapy Assistant | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2019-11-28 |
| 1790321875 | Christina Liles | Physical Therapy Assistant | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2019-11-23 |
| 1235608175 | Heather Baisey | Physical Therapy Assistant | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2018-11-21 |
| 1396229621 | Rhonda L Maitland | Physical Therapy Assistant | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2018-09-22 |
| 1154813046 | Sally Wilson | Speech-Language Pathologist | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2018-06-05 |
| 1255822318 | Barbara L Hicks | Occupational Therapy Assistant | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2018-05-24 |
| 1780109306 | Beverly Driver | Registered Nurse | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2017-08-04 |
| 1265808877 | Jessica Jones | Nurse Practitioner | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2015-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043784606 | Elizabeth Jene Ezell | Dental Hygienist | 604 N. Thomas St., South Hill, VA 23970 | 2019-01-17 |
| 1821576901 | Mackenzie Jean Blackwell | Dental Hygienist | 604 N. Thomas St, South Hill, VA 23970 | 2018-08-01 |
| 1316459357 | Bernita Danica Boyd | Contractor | 436 Theater Rd, South Hill, VA 23970 | 2017-10-31 |
| 1194242909 | More Transport LLC | Non-emergency Medical Transport (VAN) | 651 Clearview Dr, South Hill, VA 23970 | 2017-08-23 |
| 1912423534 | Larry D Warren | Driver | 730 Hite Street, Po Box 896, South Hill, VA 23970 | 2017-08-15 |
| 1902320658 | Lakika Lyshon Hicks | Non-emergency Medical Transport (VAN) | 74 Hudgins Road, South Hill, VA 23970 | 2017-08-02 |
| 1053835561 | Vernice Luevine Lewis | Driver | 11525 Highway One, South Hill, VA 23970 | 2017-07-27 |
| 1407376924 | Building Blocks To Success LLC | Occupational Therapist | 20429 Hwy Forty-seven, South Hill, VA 23970 | 2017-06-26 |
| 1316477136 | Eric Blackwell | Driver | 248 Circle Dr, South Hill, VA 23970 | 2017-06-14 |
| 1619341443 | North View Day Support LLC | Day Training, Developmentally Disabled Services | 359 Saffold Road, South Hill, VA 23970 | 2015-11-17 |
| Find all providers in zip 23970 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568803344 | Sharon Ann Marsh | Skilled Nursing Facility | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2013-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760015119 | Mikaylah Lang | Skilled Nursing Facility | 4505 Georgewashington Hwy, Portsmouth, VA 23702 | 2020-02-13 |
| 1134760432 | Valley Operator LLC | Skilled Nursing Facility | 940 E Lee Hwy, Chilhowie, VA 24319-3237 | 2019-10-08 |
| 1871134171 | Westport Operator LLC | Skilled Nursing Facility | 7300 Forest Ave, Richmond, VA 23226-3735 | 2019-10-08 |
| 1437790730 | Hopewell Operator LLC | Skilled Nursing Facility | 905 Cousins Ave, Hopewell, VA 23860-6507 | 2019-10-08 |
| 1013478411 | Blue Ridge Snf Operations LLC | Skilled Nursing Facility | 105 Landmark Dr, Stuart, VA 24171-9401 | 2019-03-28 |
| 1265924260 | Nassawadox Life Care, LLC | Skilled Nursing Facility | 9468 Hospital Road, Nassawadox, VA 23413-0176 | 2018-06-05 |
| 1518459593 | Big Stone Gap Life Care, LLC | Skilled Nursing Facility | 2045 Valley View Dr, Big Stone Gap, VA 24219-3319 | 2018-06-05 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1033660360 | Nathan Ian Dalleave | Skilled Nursing Facility | 1243 Lanier Rd, Martinsville, VA 24112-5211 | 2016-10-21 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HILL |
| Zip Code | 23970 |
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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.