NPIMap

Organization Active NPI

Memorial Medical Center

  • Psychiatric Hospital Unit
  • Springfield, IL
National Provider Identifier
1316918287
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MEMORIAL MEDICAL CENTER
Practice address
701 N 1St St
Springfield, IL 62781-0001
Phone
(217) 788-3000
NPI assigned
Jan 30, 2006
Last updated
Jun 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
Jameson M Roszhart
Title
President & Ceo
Phone
(217) 788-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62781-0001

Mailing address

701 N 1St St
Springfield, IL 62781-0001
Phone (217) 788-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000729 IL Part A Provider - Hospital 7315835949 Practice locations: Springfield, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316918287. Details of each certification follow.

Hospital certification: CCN 14S148

Legal name
MEMORIAL MEDICAL CENTER
Doing business as
SPRINGFIELD MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jan 19, 1897 in IL
Enrollment address
701 N 1St St
Springfield, IL 62781-0001
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Memorial Med Ctr15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

701 N 1st St
#528
Springfield, IL 62781

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Tara Z Bennett Individual Corporate Director Mar 1, 2025
Gregory a Matthews Individual Corporate DirectorBoard Member Jan 1, 2023
Murty S Renduchintala Individual Corporate DirectorBoard Member Jan 1, 2023
Wendi R Wills El-Amin Individual Corporate Director Jan 1, 2021
Clint W Paul Individual Corporate DirectorBoard Member Jan 1, 2023
David L Griffen Individual Corporate DirectorBoard Member Jan 1, 2023
Angela K Sowle Individual Corporate DirectorBoard Member Jan 1, 2023
Mandy C. Eaton Individual Corporate DirectorPresident & Ceo Memorial Health Sys Mar 31, 2025
Jameson Roszhart Individual Corporate OfficerPresident and Ceo Jul 1, 2024
W-2 Managing Employee Jun 15, 2009
Memorial Health System Organization, Springfield, IL Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 21, 1981 100%
Gregory Marantz Individual Corporate Director Mar 1, 2025
Amy L Beadle Individual Corporate DirectorBoard Member Jan 1, 2023
James W. Reed Individual Corporate Director Jan 1, 2016
Lynne Duren Barkmeier Individual Corporate Director Jan 1, 2014
Janet L Gooch Individual Corporate DirectorBoard Member Jan 1, 2023
Marcus E Johnson Individual Corporate DirectorBoard Member Jan 1, 2023
Kathryn J Keim Individual Other Jan 1, 2019
Vidhya Prakash Individual Corporate DirectorBoard Member Jan 1, 2023
Kirsten H Kienzler Individual Corporate DirectorBoard Member Jan 1, 2023
Marcena Urish Individual W-2 Managing EmployeeDirector Aug 10, 1998

Owners & managing parties with NPI records 6

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

Facilities with the same owner 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1316918287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-788-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "ROSZHART",
        "authorized_official_first_name": "JAMESON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "217-788-3000"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.