Memorial Healthcare Group Inc
Organization Active NPI Psychiatric Hospital Unit · Jacksonville, FL
NPI 1083997779 · NPPES record last updated Nov 5, 2025
Key facts
- NPI
- 1083997779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- Legal business name
- MEMORIAL HEALTHCARE GROUP INC
- Practice address
- 3625 University Blvd S
Jacksonville, FL 32216-4207 - Phone
- (904) 399-6111
- Fax
- (904) 399-6849
- NPI assigned
- Sep 20, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- MEMORIAL HEALTHCARE GROUP INC
Authorized official
- Name
- Kevin McKeown
- Title
- Cfo
- Phone
- (904) 702-6573
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 13
Member organizations 2
Related certifications (CCN) 1
Facilities with the same owner 63
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Hospital certification: CCN 10S179
- Legal name
- MEMORIAL HEALTHCARE GROUP INC
- Doing business as
- HCA FLORIDA MEMORIAL HOSPITAL
- Organization structure
- Corporation · Proprietary
- Incorporated
- Nov 15, 1994 in FL
- Enrollment address
- 3625 University Blvd S
Jacksonville, FL 32216-4207 - Hospital subgroups
- Acute care, Psychiatric unit
All disclosed owners & managing parties 48
| Name | Role | Since | Share |
|---|---|---|---|
| Michael McAlevey |
Corporate Officer | Feb 1, 2022 | |
| Jaime L Derensis |
Corporate Officer | Nov 4, 2020 | |
| HCA Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2012 | 100% |
| John M Franck |
Corporate Officer | Apr 18, 2016 | |
| Corporate Director | Apr 18, 2016 | ||
| Columbia Jacksonville Healthcare System Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2012 | 100% |
| Douglas L Downey |
Corporate Officer | Apr 18, 2016 | |
| Eric D Smith |
Other |
Mar 1, 2021 | |
| HCA Healthcare Inc |
5% Or Greater Indirect Ownership Interest | May 10, 2016 | 100% |
| Melissa J Egan |
Corporate Officer | Nov 4, 2020 | |
| Henry Todd Maxwell |
Corporate Officer | Jan 1, 2024 | |
| Frisco Holding II |
5% Or Greater Indirect Ownership Interest | Feb 6, 2026 | 16.3% |
| Gregary W Beasley |
Corporate Officer | Apr 18, 2016 | |
| Christopher F Wyatt |
Corporate Officer | Apr 18, 2016 | |
| Corporate Director | Apr 18, 2016 | ||
| John I Starling |
Corporate Officer | Oct 7, 2019 | |
| Brennon Reed Hammond |
Corporate Officer | Jun 1, 2023 | |
| W-2 Managing Employee |
Jun 1, 2023 | ||
| Shirley E Scharf-Cheatham |
Corporate Officer | Apr 18, 2016 | |
| Richard Hammett |
Corporate Officer | Jan 1, 2023 | |
| Julie Wickwire |
Corporate Officer | Apr 18, 2016 | |
| Brittain W Sexton |
Corporate Officer | Jan 1, 2023 | |
| John M Hackett |
Corporate Officer | Apr 18, 2016 | |
| David W. McKnight |
Corporate Officer | Sep 5, 2025 | |
| Hercules Holding II |
5% Or Greater Indirect Ownership Interest | May 10, 2016 | 14.4% |
| Samuel N Hazen |
Corporate Officer | Apr 18, 2016 | |
| Corporate Director | Apr 18, 2016 | ||
| Ronald Lee Grubbs |
Corporate Officer | Apr 18, 2016 | |
| Monica Cintado |
Corporate Officer | Oct 7, 2019 | |
| Jon Foster |
Corporate Officer | Jan 1, 2023 | |
| Sean Boyette |
Corporate Officer | Jan 1, 2023 | |
| Healthtrust Inc - the Hospital Company |
5% Or Greater Indirect Ownership Interest | May 10, 2016 | 100% |
| Galen Holdco LLC |
5% Or Greater Indirect Ownership Interest | May 10, 2016 | 100% |
| Shaun Cartwright |
Corporate Officer | Sep 5, 2025 | |
| Seth a Killingbeck |
Corporate Officer | Apr 18, 2016 | |
| Ricardo Pavon |
Corporate Officer | Oct 1, 2020 | |
| Timothy Scott Noonan |
Corporate Officer | Apr 18, 2016 | |
| Natalie H Cline |
Corporate Officer | Apr 18, 2016 | |
| Michael T Bray |
Corporate Officer | Apr 18, 2016 | |
| Ryan M. Miller |
Corporate Officer | Sep 5, 2025 | |
| Matthew R Favicchio |
Corporate Officer | Sep 5, 2025 | |
| Peter J Rossell |
Corporate Officer | Jan 1, 2023 | |
| Edward Tennant |
Corporate Officer | Apr 18, 2016 | |
| Ashley T Lacaze |
Corporate Officer | Apr 15, 2019 | |
| Michael a Marks |
Corporate Officer | Sep 5, 2025 | |
| Edwin W Robinson |
Corporate Officer | Sep 5, 2025 | |
| Brad Ej Spicer |
Corporate Officer | Jan 1, 2023 | |
| Hugh Carter Tappan |
Corporate Officer | Apr 18, 2016 | |
| Kevin a Ball |
Corporate Officer | Apr 18, 2016 | |
| Jeffery McInturff |
Corporate Officer | Nov 29, 2021 | |
| Deborah H Mullin |
Corporate Officer | Apr 18, 2016 | |
| Sudeep Singh |
Corporate Officer | Sep 5, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120921000787 | FL | Part a Provider - Hospital | 5799788303 | Practice locations: Jacksonville, FL |
National Provider Directory
- Tax ID family
- Memorial Medical Center
- Part of
- Memorial Medical Center
Locations
10475 Centurion Pkwy N
Ste 100
Jacksonville, FL 32256
Phone (904) 928-1001
3627 University Blvd S
Fl 1
Jacksonville, FL 32216
Phone (904) 399-6111
3627 University Blvd S
Fl 8
Jacksonville, FL 32216
Phone (904) 702-6377
10910 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 407-8500
14444 Beach Blvd
Jacksonville Beach, FL 32250
Phone (904) 858-7510
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | Yes |
Addresses
Primary practice location
3625 University Blvd S
Jacksonville, FL 32216-4207
Mailing address
3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 399-6111
Other names
- HCA Florida Memorial Hospital
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Jacksonville, FL
- Memorial Family Practice Associates LLC
- Memorial Family Practice Associates, LLC
- Memorial Family Practice Associates, LLC
- Memorial Family Practice, LLC
- Memorial Healthcare Group Inc
- Memorial Healthcare Group Inc
- Memorial Healthcare Group Inc
- Memorial Healthcare Group Inc
- Memorial Healthcare Group Inc
- Memorial Healthcare Group Inc
All providers in Jacksonville, FL · Psychiatric Hospital Unit in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.