NPIMap

Organization Active NPI

Memorial Hospital of Union County

Doing business as Memorial Urgent Care

  • Urgent Care Clinic/Center
  • Marysville, OH
National Provider Identifier
1093763757
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEMORIAL HOSPITAL OF UNION COUNTY
Doing business as
Memorial Urgent Care
Practice address
120 Coleman's Crossing Blvd
Marysville, OH 43040-9797
Phone
(937) 578-4310
Fax
(937) 578-4347
NPI assigned
May 5, 2006
Last updated
Oct 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Olas A. (Chip) Hubbs III
Title
President and Ceo
Phone
(937) 578-2288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

120 Coleman's Crossing Blvd
Marysville, OH 43040-9797

Mailing address

500 London Ave
Attn: Spence Fisher
Marysville, OH 43040-5512
Phone (937) 644-6115

Other practice location 1

1958 E US Highway 36
Urbana, OH 43078-9799
Phone (937) 652-5019

Other names 1

  • Memorial Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150403000975 OH Part B Supplier - Clinic/Group Practice 3577551621 Receives reassigned benefits from 41 practitioners
Practice locations: Urbana, OH; Marysville, OH; Plain City, OH

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1056805Memorial Hospital of Union County Dba120 Coleman's Crossing Blvd, Marysville, OH 43040Certificate of waiverNov 29, 2026
36D2112186Memorial Hospital120 Coleman's Crossing Boulevard, Marysville, OH 43040Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Union County

    dba Union County Health Department

    • Community Health Clinic/Center
    • Marysville, OH
    • NPI 1104875541

    Member Of

    NPD member

Locations

120 Colemans Crossing Blvd
Marysville, OH 43040
Phone (937) 578-4200

11850 Sycamore Trce
Ste A
Plain City, OH 43064
Phone (614) 881-3473

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1093763757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LONDON AVE",
            "address_2": "ATTN: SPENCE FISHER",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430405512",
            "telephone_number": "937-644-6115",
            "fax_number": "937-578-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 COLEMAN'S CROSSING BLVD",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430409797",
            "telephone_number": "937-578-4310",
            "fax_number": "937-578-4347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1958 E US Highway 36",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "OH",
            "postal_code": "430789799",
            "country_code": "US",
            "telephone_number": "937-652-5019",
            "fax_number": "937-652-1958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL OF UNION COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "HUBBS",
        "authorized_official_first_name": "OLAS",
        "authorized_official_middle_name": "A. (CHIP)",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "937-578-2288",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.