NPIMap

Organization Active NPI

Doctors Memorial Hospital Inc

  • Critical Access Hospital
  • Perry, FL
National Provider Identifier
1427092006
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 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
Last updated
Nov 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Mrs. Sara A Grambling
Title
VP, Operations
Phone
(850) 584-0643

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X FL
Critical Access Hospital 282NC0060X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427092006. Details of each certification follow.

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
CorporationNon-profit
Incorporated
May 15, 1992 in FL
Enrollment address
333 N Byron Butler Pkwy
Perry, FL 32347-2300
Other Hospital Practice Location

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).

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
Doctors Memorial Hospital IncCCN 101314 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Sara Grambling Individual Corporate Director Jul 10, 2008
W-2 Managing EmployeePFS Director Sep 13, 2004
Judy Dorman Individual W-2 Managing Employee Apr 21, 2000

Practitioners & affiliated clinicians

Practitioners 11

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.

Affiliated clinicians 157

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

View all 157

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1427092006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N BYRON BUTLER PKWY",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472300",
            "telephone_number": "850-584-0800",
            "fax_number": "850-223-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N BYRON BUTLER PKWY",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472300",
            "telephone_number": "850-584-0800",
            "fax_number": "850-223-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "GRAMBLING",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP, OPERATIONS",
        "authorized_official_telephone_number": "850-584-0643",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, FL

Sources for this page

Verify at the official NPI Registry.