NPIMap

Organization Active NPI

Memorial Health Care System Inc.

Doing business as Memorial Hospital

  • General Acute Care Hospital
  • Chattanooga, TN
National Provider Identifier
1255428736
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0000000071 Issued in TN
Legal business name
MEMORIAL HEALTH CARE SYSTEM INC.
Doing business as
Memorial Hospital
Practice address
2525 Desales Ave
Chattanooga, TN 37404-1161
Phone
(423) 495-2525
Fax
(423) 495-6312
NPI assigned
Oct 6, 2006
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Michael Sutton
Title
Vice President, Finance
Phone
(423) 495-8488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0000000071 TN Primary

Addresses

Primary practice location

2525 Desales Ave
Chattanooga, TN 37404-1161

Mailing address

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525

Other identifiers 2

IdentifierTypeStateIssuer
00236662AMedicaidGA
0440091MedicaidTN

Other names 1

  • Memorial Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040110000188 TN Part B Supplier - Clinic/Group Practice 8628978210 Receives reassigned benefits from 66 practitioners
1 other NPI on this enrollment
Practice locations: Dayton, TN; Ringgold, GA; Kimball, TN; Hixson, TN; Chattanooga, TN
O20080925000402 TN Part A Provider - Hospital 8628978210 1 other NPI on this enrollment
Practice locations: Ooltewah, TN; Hixson, TN; Cleveland, TN; Chattanooga, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255428736. Details of each certification follow.

Hospital certification: CCN 440091

Legal name
MEMORIAL HEALTH CARE SYSTEM INC.
Doing business as
MEMORIAL HOSPITAL/MEMORIAL HOSPITAL HIXSON-CHI MEMORIAL/ CHI MEMORIAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 22, 2000
Beds
431
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Aug 7, 1984 in KY
Enrollment address
2525 Desales Ave
Chattanooga, TN 37404-1161
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Memorial Healthcare System, IncCCN 440091 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

39000 Bob Hope Dr
Ste 310
Rancho Mirage, CA 92270

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Doug Lawson Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Michael Steines Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Gary Whitlock Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Nov 27, 2007 100%
Operational/Managerial Control Nov 27, 2007
Craig a Nielsen Individual Corporate OfficerMKT VP Operational Finance Jul 1, 2023
Operational/Managerial ControlMKT VP Operational Finance Jul 1, 2023
Robert Upchurch Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Matthew Brown Individual Corporate OfficerBoard Member, President Jul 1, 2025
Corporate DirectorBoard Member, President Jul 1, 2025
Frank Ashley Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Terika Richardson Mbanu Individual Corporate OfficerPresident, CSH Jan 5, 2024
Corporate DirectorBoard Member Jul 1, 1978
Donald D Hearne Individual Corporate OfficerSecretary Jul 1, 2025
Janelle G Reilly Individual Corporate OfficerMarket President Jul 1, 2018
Operational/Managerial ControlMarket Ceo Oct 1, 2018
Brooks Bass Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Brad Beers Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Thomas Kopfensteiner Individual Corporate DirectorBoard Member Jul 1, 2025
Jane Ainsworth Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Monte J Bostwick Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Indira S Anupindi Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Demetress L Harrell Individual Corporate DirectorAdvisory Board Member Jul 1, 2025

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Commonspirit-Memorial Hospital-North GeorgiaRinggold, GA, CCN 110236 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 29, 2017

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 174

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 174

Affiliated clinicians 1,139

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,139

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1255428736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-495-2525",
            "fax_number": "423-495-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-495-2525",
            "fax_number": "423-495-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HEALTH CARE SYSTEM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, FINANCE",
        "authorized_official_telephone_number": "423-495-8488"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "0000000071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00236662A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440091",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.