NPIMap

Organization Active NPI

Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • Dayton, TN
National Provider Identifier
1144633397
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MEMORIAL HEALTH PARTNERS FOUNDATION INC
Practice address
7693 Rhea County Hwy Ste 3
Dayton, TN 37321-6083
Phone
(423) 570-8545
Fax
(423) 570-0326
NPI assigned
Jun 5, 2014
Organization subpart
No

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 4

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 459

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 459

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
44D1000489Memorial Health Partners Foundation, Inc7693 Rhea County Hwy, Suite 3, Dayton, TN 37321Certificate of waiverJun 16, 2028

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221130003684 TN Part A Provider - Rural Health Clinic 8022919570 Practice locations: Dayton, TN

Rural health clinic certification: CCN 883949

Legal name
MEMORIAL HEALTH PARTNERS FOUNDATION, INC
Doing business as
CHI MEMORIAL HORTON FAMILY PRACTICE ASSOCIATES-DAYTON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 6, 2023
Last certification
Sep 6, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 2002 in TN
Enrollment address
7693 Rhea County Hwy
Ste 3
Dayton, TN 37321-6083

All disclosed owners & managing parties 11

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daniel L Heithold Individual Corporate OfficerBoard Member Dec 1, 2019 9.09%
Corporate DirectorBoard Member Dec 1, 2019 9.09%
W-2 Managing EmployeeBoard Member Dec 1, 2019 9.09%
Janelle G Reilly Individual Corporate OfficerBoard Member Dec 1, 2019 9.09%
Corporate DirectorBoard Member Dec 1, 2019 9.09%
Franklin H Baker Individual Corporate OfficerBoard Member Aug 1, 2022 9.09%
Corporate DirectorBoard Member Aug 1, 2022 9.09%
W-2 Managing EmployeeBoard Member Aug 1, 2022 9.09%
David P Foster Individual Corporate OfficerBoard Member Dec 1, 2019 9.09%
Corporate DirectorBoard Member Dec 1, 2019 9.09%
Derek Crouthers Individual Corporate Officer Jul 1, 2023
Rachel D Labovitz Individual Corporate Officer Jul 25, 2024
Maelor Glyn Hughes Individual Corporate Officer Sep 29, 2023
W-2 Managing Employee Sep 29, 2023
Memorial Health Partners Foundation, Inc Organization, Chattanooga, TN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 21, 2002 100%
Operational/Managerial Control Mar 21, 2002 100%
Owen F Speer Individual Corporate Officer Aug 1, 2025
Rishabh Nikhil Shah Individual Corporate Officer Aug 1, 2025
Charles L Jackson Individual Corporate Officer Sep 25, 2024

All facility ownership & control disclosures 2

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CHI Memorial Family Practice Associates - Spring CitySpring City, TN, CCN 883948 Rural health clinic Operational/Managerial Control (100%) Mar 21, 2002
CHI Memorial Family Practice Associates - LafayetteLa Fayette, GA, CCN 118921 Rural health clinic Operational/Managerial Control (100%) Mar 21, 2002

National Provider Directory

National Provider Directory
Tax ID family
Memorial Health Partners2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Mr. Maelor G Hughes
Title
President
Phone
(423) 495-8659

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

7693 Rhea County Hwy Ste 3
Dayton, TN 37321-6083

Mailing address

PO Box 749748
Atlanta, GA 30374-9748
Phone (423) 790-7750

Other names 1

  • CHI Memorial Horton Family Practice Associates - Dayton Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1144633397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749748",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749748",
            "telephone_number": "423-790-7750",
            "fax_number": "423-790-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7693 RHEA COUNTY HWY STE 3",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373216083",
            "telephone_number": "423-570-8545",
            "fax_number": "423-570-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HEALTH PARTNERS FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "MAELOR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-495-8659",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Memorial Horton Family Practice Associates - Dayton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, TN

Sources for this page

Verify at the official NPI Registry.