Memorial Health Systems Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MEMORIAL HEALTH SYSTEMS INC

Practice address

61 Memorial Medical Pkwy Ste 2811
Palm Coast, FL 32164-5999

Phone

(386) 671-4519

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Cory Domayer

Title

VP

Phone

(383) 231-3906

Specialties & licenses 4

Addresses

Other names 1

• AdventHealth Medical Group Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1275640997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730729",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321730729",
            "telephone_number": "386-671-4500",
            "fax_number": "386-672-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY STE 2811",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645999",
            "telephone_number": "386-671-4519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Sterthaus Ave",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321745131",
            "country_code": "US",
            "telephone_number": "386-671-4500",
            "fax_number": "386-672-9904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEMORIAL HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "DOMAYER",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "383-231-3906"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Melendez, LCSW
• Mayeisi Melgarejo, RBT
• Becki D Melton, MD
• Lacy Lynn Melton, M.S.
• Amos Melvin Jr., BC-HIS
• Memorial Hospital Flagler Inc
• Memorial Hospital Flagler Inc
• Memorial Hospital Flagler Inc
• Memorial Hospital Flagler Inc.
• Bryan Mendes, PT, DPT

• All providers in Palm Coast, FL
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.