Doctors Memorial Hospital Inc
Organization Active NPI Critical Access Hospital · Perry, FL
NPI 1427092006 · NPPES record last updated Nov 2, 2023
Key facts
- NPI
- 1427092006
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- DOCTORS MEMORIAL HOSPITAL INC
- Practice address
- 333 N Byron Butler Pkwy
Perry, FL 32347-2300 - Phone
- (850) 584-0800
- Fax
- (850) 223-2308
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Sara A Grambling
- Title
- VP, Operations
- Phone
- (850) 584-0643
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 5
Related certifications (CCN) 2
Practitioners 25
-
Lise M. Casady, ARNP
-
Virginia Paige Bodell, FNP-C
-
Thomas R Eckler II, M.D.
-
Macy Ely, DNP, ARNP, FNP-C
-
Ramel Failma, MD
-
Kasey Tuten Hughey, FNP-C, PMHNP-BC
-
Miles V Nelson, M.D.
-
Tiffanee Ann Padgett, ARNP
-
Cara Lee Pappas, ND ACNP FNP
-
Colby Redfield, M.D.
-
Sarah Caitlyn Straka, APRN, FNP-C
-
Tae Yu, DO
-
Ashley Abt, PA
-
William David Houston, FNP-C
-
Hillary Byrd, ARNP
-
Sarah Elizabeth Cayson, APRN
-
Jenna I Culpepper, APRN
-
Wade G Douglas, MD
-
Melissa Harris, APRN
-
Gary Johnston Jr., DNP, APRN-C
-
Yawen Ping, ARNP-C
-
Leslie Samuels, APRN
Affiliated clinicians 157
-
Susan Alvarez, ARNP
-
Robert David Ambre II, PA-C
-
Christopher Wade Babl, M.D.
-
Gregory J Bailey, MD
-
Bradley P. Barnes, M. D.
-
Julia Barry, D.O.
-
Venkata V Bavikati, MBBS, MPH
-
Thomas N. Bialkowski, PA-C
-
Gent Bitincka, M.D
-
Shana Lesti Blakeney, CNFP
-
Jillian Ward Bowdoin, ARNP
-
Whitson Hines Boyd, PA-C
-
Christie Brooks, APRN
-
Hillary Byrd, ARNP
-
Carlos E Campo, M.D.
Medicare Care Compare: Hospital
- Listed as
- Doctors Memorial Hospital Inc
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL
Hospital certification: CCN 101314
- Legal name
- DOCTORS MEMORIAL HOSPITAL INC
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Oct 27, 2023
- Last certification
- Oct 12, 2023
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 15, 1992 in FL
- Enrollment address
- 333 N Byron Butler Pkwy
Perry, FL 32347-2300
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Sara Grambling |
Corporate Director | Jul 10, 2008 | |
| W-2 Managing Employee |
Sep 13, 2004 | ||
| Judy Dorman |
W-2 Managing Employee | Apr 21, 2000 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040114000009 | FL | Part B Supplier - Clinic/Group Practice | 5092614503 |
Receives reassigned benefits from 49 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Perry, FL |
| O20231107000131 | FL | Part a Provider - Critical Access Hospital | 5092614503 | Practice locations: Perry, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | FL | ||
| Critical Access Hospital | 282NC0060X | Yes |
Addresses
Primary practice location
333 N Byron Butler Pkwy
Perry, FL 32347-2300
Mailing address
333 N Byron Butler Pkwy
Perry, FL 32347-2300
Phone (850) 584-0800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24274A | Other | FL | MEDICARE GROUP PART B |
| 427 | Other | FL | BLUE CROSS |
| 01080000 | Medicaid | FL |
Other providers in Perry, FL
- Doctors Memorial Hospital Based Physicians Group
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital Inc
- Doctors Memorial Hospital, Inc
All providers in Perry, FL · Critical Access Hospital in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.