MEMORIAL HEALTH SYSTEMS INC (NPI# 1922115914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922115914 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HEALTH SYSTEMS INC |
| Other Organization Name | ADVENTHEALTH MEDICAL GROUP |
| Practice Address |
305 Memorial Medical Pkwy Ste 205 Daytona Beach FL 32117-5169 |
| Mailing Address |
770 W Granada Blvd Ste 203 Ormond Beach FL 32174-5179 |
| Practice Telephone | 3862313530 |
| Mailing Telephone | 8632314252 |
| Mailing Fax Number | 3866762560 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2019-08-06 |
| Authorized Official Name | CULLY CHAPMAN (CFO) |
| Authorized Official Telephone | 3862313906 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE ID UNSPECIFIED | 40181J | 01 |
| Other Name | Type Code |
|---|---|
| AdventHealth Medical Group | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1050 W Granada Blvd Ste 2a, Ormond Beach, FL 321748155 | 3862313050 | |
| 1890 Lpga Blvd Ste 170, Daytona Beach, FL 321177131 | 3862743354 | |
| 1893 N Clyde Morris Blvd Ste 100, Daytona Beach, FL 321175536 | 3866770531 | |
| 290 Clyde Morris Blvd Ste A2, Ormond Beach, FL 321748204 | 3862313490 | |
| 301 Memorial Medical Pkwy, Daytona Beach, FL 321175167 | 3862316000 | |
| 305 Memorial Medical Pkwy Ste 201, Daytona Beach, FL 321175169 | 3862313530 | |
| 305 Memorial Medical Pkwy Ste 205, Daytona Beach, FL 321175169 | 3862313530 | |
| 305 Memorial Medical Pkwy Ste 207, Daytona Beach, FL 321175169 | 3862313525 | |
| 305 Memorial Medical Pkwy Ste 208, Daytona Beach, FL 321175169 | 3862313593 | 3866729904 |
| 305 Memorial Medical Pkwy Ste 209, Daytona Beach, FL 321175169 | 3862313520 | |
| 305 Memorial Medical Pkwy Ste 307, Daytona Beach, FL 321175169 | 3862313512 | |
| 305 Memorial Medical Pkwy Ste 308, Daytona Beach, FL 321175137 | 3862313602 | |
| 305 Memorial Medical Pkwy Ste 400, Daytona Beach, FL 321175169 | 3862313580 | |
| 305 Memorial Medical Pkwy Ste 401, Daytona Beach, FL 321175169 | 3862313612 | |
| 335 Clyde Morris Blvd Ste 240, Ormond Beach, FL 321743197 | 3862313561 | |
| 5535 S Williamson Blvd Ste 700, Port Orange, FL 321288321 | 3862316300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275640997 | Memorial Health Systems Inc | Family Medicine | 61 Memorial Medical Pkwy Ste 2811, Palm Coast, FL 32164-5999 | 2006-08-25 |
| 1598860108 | Memorial Health Systems Inc | Rehabilitation Unit | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2006-09-14 |
| 1720195449 | Memorial Health Systems Inc | Internal Medicine | 875 Sterthaus Ave, Ormond Beach, FL 32174-5131 | 2006-08-25 |
| 1548377260 | Memorial Health Systems Inc | Family Medicine | 875 Sterthaus Ave, Ormond Beach, FL 32174-5131 | 2006-08-25 |
| 1366559080 | Memorial Health Systems Inc | Family Medicine | 875 Sterthaus Ave, Ormond Beach, FL 32174-5131 | 2006-08-25 |
| 1063426823 | Memorial Health Systems Inc | General Acute Care Hospital | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2006-07-28 |
| Street Address |
305 MEMORIAL MEDICAL PKWY STE 205 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487285953 | Katherine Dinan | Nurse Practitioner | 305 Memorial Medical Pkwy Ste 205, Daytona Beach, FL 32117-5169 | 2020-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548674724 | Andrew Fritze | Surgery | 201 N Clyde Morris Blvd Ste 100, Daytona Beach, FL 32114-2765 | 2014-06-16 |
| 1659534063 | Gregory Brent Burgoyne | Surgery | 305 Memorial Medical Pkwy Ste 209, Daytona Beach, FL 32117-5169 | 2008-07-07 |
| 1679766943 | Kyle A Herron | Surgery | 1890 Lpga Blvd Ste 255, Daytona Beach, FL 32117-7207 | 2007-08-21 |
| 1306870704 | Rodrigo Bleza Mateo | Surgery | 311 North Clyde Morris Blvd., Suite 480, Halifax Center for Transplant Services, Daytona Beach, FL 32114-2766 | 2006-07-10 |
| 1457395543 | Stephen H Levine | Surgery | 311 N Clyde Morris Blvd Ste 70, Daytona Beach, FL 32114-2756 | 2006-06-16 |
| 1982641494 | Slobodan Jazarevic | Surgery | 311 N Clyde Morris Blvd Ste 300, Daytona Beach, FL 32114 | 2006-06-01 |
| 1639122880 | Bruce John Ramshaw | Surgery | 201 N Clyde Morris Blvd., Suite 205, Daytona Beach, FL 32114-2765 | 2006-05-18 |
| 1982691077 | Harry H Black | Surgery | 201 North Clyde Morris Blvd, Suite 100, Daytona Beach, FL 32114-2724 | 2005-10-04 |
| 1639166739 | Joel L Sebastien | Surgery | 201 North Clyde Morris Blvd., Suite 100, Daytona Beach, FL 32114-2724 | 2005-10-04 |
| 1306838545 | Christopher Allen Grove | Surgery | 305 Memorial Medical Pkwy, Suite 201, Daytona Beach, FL 32117-5168 | 2005-08-15 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on MEMORIAL HEALTH SYSTEMS INC.
| 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.