Memorial Hospital

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

000478 Issued in TX

Legal business name

MEMORIAL HOSPITAL

Practice address

1204 N Mound St
Nacogdoches, TX 75961-4027

Phone

(936) 564-4611

NPI assigned

Jul 5, 2006

Last updated

Aug 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jane Ann Bridges, CPA

Title

Chief Financial Officer

Phone

(936) 568-8525

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Nacogdoches County Hospital District

  dba Nacogdoches Memorial Professional Group

  • Obstetrics & Gynecology Physician
  • Nacogdoches, TX
  • NPI 1053711804

  O20040608000604

  Same enrollment
• Nacogdoches County Hospital District

  dba NCHD Memorial Hospital

  • Rural Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1801831748

  O20040608000604

  Same enrollment

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/4e999ac6-c999-420e-9519-39e393fb5133/

Practitioners 1

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.

• Kristin Nicole Robinson, APRN

  • Nurse Practitioner
  • Nacogdoches, TX
  • NPI 1063053197
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1215968748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-564-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-564-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "936-568-8525",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": "TX",
            "license": "000478",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "000478",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "000478",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "000478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Arts Surgery Center LLC
• Maria Guadalupe Medina
• Stephanie Medina, ATC
• Medquinox
• Maegan Melton
• Memorial Hospital
• Memorial Hospital (Hospice of Deep East Texas)
• Maura Colleen Messer
• Christina Baumgart Meyers, LPC
• Sylvia Middlebrook, PH.D.

• Emergency Medicine Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.