MEMORIAL MEDICAL CENTER (NPI# 1679549968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679549968 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER |
| Other Organization Name | THE HEARING CENTER AT MEMORIAL |
| Practice Address |
644 North Second Street Springfield IL 62781-0001 |
| Practice Telephone | 2177883767 |
| Practice Fax Number | 2177887093 |
| Mailing Telephone | 2177883767 |
| Mailing Fax Number | 2177887093 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT T CLARKE (PRESIDENT AND CEO) |
| Authorized Official Telephone | 2177883340 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers |
| Other Name | Type Code |
|---|---|
| The Hearing Center at Memorial | 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 |
| 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 |
| 1164954806 | Memorial Medical Center | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-03-31 |
| 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 |
644 NORTH SECOND STREET |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62781-0001 |
| 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 |
| 1992187934 | Kelli Levek | Emergency Medicine | 701 N 1st St, Springfield, IL 62781 | 2015-06-26 |
| 1386048502 | Bhadreshkumar R. Mandani | Family Medicine | 701 N 1st St, Springfield, IL 62781 | 2014-10-17 |
| 1801215231 | Robert Matthew Tennill | Emergency Medicine | 701 N 1st St, Springfield, IL 62781 | 2014-04-14 |
| 1851739684 | Mateusz Serafin | Hospitalist | 701 N 1st St, Springfield, IL 62781 | 2013-06-14 |
| 1538506357 | Sapna Siddharth | Internal Medicine | 701 N 1st St, Springfield, IL 62781 | 2013-06-03 |
| 1336586734 | Rakshit Ramanath Shetty | Internal Medicine | 701 N 1st St, Springfield, IL 62781 | 2013-05-28 |
| Find all providers in zip 62781 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760944565 | Hearing and Audiology Sevices, LLC | Audiologist | 1722 S Glenstone Ave Ste J1, Springfield, MO 65804-1530 | 2019-04-02 |
| 1649742982 | Abdullah M Jamos | Audiologist | 3106 E Kingsley St, Springfield, MO 65804-6689 | 2018-12-27 |
| 1326569609 | Decia Ann Demaio | Audiologist | 175 Carew St Ste 150, Springfield, MA 01104-2391 | 2017-06-27 |
| 1497197479 | Lindsay B Hobbs | Audiologist | 4145 S National Ave, Springfield, MO 65807-5356 | 2013-07-19 |
| 1508173790 | Liliana Cabrera Piccinini | Audiologist | 760 W Sproul Rd Ste 103, Springfield, PA 19064-4003 | 2010-09-09 |
| 1912212226 | Paloma M Robinson | Audiologist | 8314-c Traford Lane, Springfield, VA 22152 | 2010-08-11 |
| 1205166642 | Matthew R Kelley | Audiologist | 100 Wason, Suite 100, Springfield, MA 01107 | 2010-01-07 |
| 1003011743 | Marta Kay Fraker | Audiologist | 3250 E Battlefield St Ste N, Springfield, MO 65804-4081 | 2007-06-20 |
| 1275736332 | Nancy J Urcuioli | Audiologist | 100 Wason Ave Ste 100, Springfield, MA 01107-1179 | 2007-06-07 |
| 1790817021 | Hdn Sheppard Acquisition Inc. | Audiologist | 1905 W North St, Springfield, OH 45504-2956 | 2007-03-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62781 |
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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.