NPIMap

Organization Active NPI

Memorial Hospital Inc

  • Rural Acute Care Hospital
  • Beverly, KY
National Provider Identifier
1104443654
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
MEMORIAL HOSPITAL INC
Practice address
53 Queendale Ctr Ste 200
Beverly, KY 40913-9608
Phone
(606) 598-4525
Fax
(606) 599-2549
NPI assigned
Jul 1, 2020
Last updated
Jan 13, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVENTHEALTH SUNBELTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Christopher Self
Title
Ceo
Phone
(606) 598-5104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X Primary

Addresses

Primary practice location

53 Queendale Ctr Ste 200
Beverly, KY 40913-9608

Mailing address

53 Queendale Ctr Ste 200
Beverly, KY 40913-9608
Phone (606) 598-4525

Other names 1

  • AdventHealth Sports Med and Rehab Red Bird Other name

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital8 organizations share this tax ID, including this one
Part of
Adventist Health System Sunbelt Healthcare Corporation

Other organizations with this tax ID 7

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

Locations

53 Queendale Ctr
Ste 200
Beverly, KY 40913
Phone (606) 598-4525

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1104443654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 QUEENDALE CTR STE 200",
            "city": "BEVERLY",
            "state": "KY",
            "postal_code": "409139608",
            "telephone_number": "606-598-4525",
            "fax_number": "606-599-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 QUEENDALE CTR STE 200",
            "city": "BEVERLY",
            "state": "KY",
            "postal_code": "409139608",
            "telephone_number": "606-598-4525",
            "fax_number": "606-599-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTHEALTH SUNBELT",
        "enumeration_date": "2020-07-01",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-598-5104"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Sports Med and Rehab Red Bird",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "AdventHealth Sports Med and Rehab Red Bird",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beverly, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.