NPIMap

Organization Active NPI

Memorial Health Systems Inc

Doing business as Adventhealth Daytona Beach

  • Cardiac Rehabilitation Clinic/Center
  • Daytona Beach, FL
National Provider Identifier
1003569492
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiac Rehabilitation Clinic/CenterTaxonomy code 261QR0404X
Legal business name
MEMORIAL HEALTH SYSTEMS INC
Doing business as
Adventhealth Daytona Beach
Florida Hospital Memorial Medical Center
Practice address
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone
(386) 231-6000
NPI assigned
Jan 27, 2022
Last updated
Feb 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HEALTH SYSTEMS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cory Douglas Domayer
Title
Cfo
Phone
(386) 231-3906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiac Rehabilitation Clinic/Center 261QR0404X Primary

Addresses

Primary practice location

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167

Mailing address

707 W Granada Blvd
Ste 203
Ormond Beach, FL 32174-5179
Phone (386) 231-4252

Other names 2

  • ADVENTHEALTH DAYTONA BEACH Doing business as
  • FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other HIH

National Provider Directory

National Provider Directory
Tax ID family
Memorial Helath Center11 organizations share this tax ID, including this one
Part of
Memorial Helath Center

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

707 W Granada Blvd
Ste 203
Ormond Beach, FL 32174

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1003569492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W GRANADA BLVD",
            "address_2": "STE 203",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745179",
            "telephone_number": "386-231-4252",
            "fax_number": "386-676-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175167",
            "telephone_number": "386-231-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HEALTH SYSTEMS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH SYSTEMS INC",
        "enumeration_date": "2022-01-27",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "DOMAYER",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "386-231-3906"
    },
    "taxonomies": [
        {
            "code": "261QR0404X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Cardiac Facilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH DAYTONA BEACH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ADVENTHEALTH DAYTONA BEACH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.