NPIMap

Organization Active NPI

Memorial Health Systems Inc

Doing business as AdventHealth Daytona Beach

  • Rehabilitation Hospital Unit
  • Daytona Beach, FL
National Provider Identifier
1598860108
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
4201 Issued in FL
Legal business name
MEMORIAL HEALTH SYSTEMS INC
Doing business as
AdventHealth Daytona Beach
Florida Hospital Oceanside
Practice address
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone
(386) 231-6000
Fax
(386) 231-1298
NPI assigned
Sep 14, 2006
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HEALTH SYSTEMS INC FLORIDA HOSPITAL ORMOND MEMORIALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Cory Domayer
Title
Cfo
Phone
(386) 231-3906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 4201 FL Primary

Addresses

Primary practice location

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167

Mailing address

770 W Granada Blvd Ste 203
Ormond Beach, FL 32174-5179
Phone (386) 231-4610

Other names 2

  • AdventHealth Daytona Beach Doing business as
  • Florida Hospital Oceanside Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other HIH
CONNECT URL https://www.mettles.com/ Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080827000755 FL Part A Provider - Hospital 9739081142 Practice locations: Daytona Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598860108. Details of each certification follow.

Hospital certification: CCN 10T068

Legal name
MEMORIAL HEALTH SYSTEMS INC
Doing business as
ADVENTHEALTH DAYTONA BEACH
Organization structure
CorporationNon-profit
Incorporated
Aug 18, 1961 in FL
Enrollment address
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Adventhealth Daytona BeachCCN 10T068 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Ear Nose Throat Assoc11 organizations share this tax ID, including this one
Part of
Ear Nose Throat Assoc

Other organizations with this tax ID 10

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

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 34

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

NameRoleSinceShare
Ketul R Patel Individual Corporate DirectorDirector Jan 1, 2023
Debora H Thomas Individual Corporate OfficerAssistant Secretary Aug 24, 2023
Corporate DirectorDirector Aug 24, 2023
Philip Maroney Individual Corporate DirectorDirector Sep 17, 2020
Douglas Hilliard Individual Corporate OfficerAsst Secretary Aug 21, 2025
John J Adams Individual Corporate DirectorDirector Feb 21, 2013
Gloria Ceballos Individual Corporate DirectorDirector Aug 17, 2023
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Meetesh S Desai Individual Corporate DirectorDirector Feb 18, 2021
Diane Godfrey Individual Corporate OfficerAsst Secretary Dec 11, 2025
Robert Deininger Individual Corporate OfficerAsst Secretary, Chair Jun 13, 2025
Corporate DirectorDirector Jun 13, 2025
Andrea Hooper Individual Corporate DirectorDirector Aug 24, 2023
Michael Saunders Individual Corporate OfficerAssistant Secretary Feb 22, 2007
Paul C Rathbun Individual Corporate OfficerAssistant Secretary Sep 11, 2014
David a Burt Individual Corporate DirectorDirector Jan 1, 2009
Dennis a Hernandez Individual Corporate DirectorDirector Apr 28, 2022
David a Weis Individual Corporate OfficerPresident Aug 28, 2022
Francis Owens Individual Contracted Managing Employee Feb 15, 2026
Corporate OfficerCfo Feb 15, 2026
Operational/Managerial ControlCfo Feb 15, 2026
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Oct 1, 2000 100%
Amanda Brady Individual Corporate OfficerAssistant Secretary Feb 27, 2020
Toni Berrios Individual Corporate OfficerAssistant Secretary Aug 25, 2022
Haney Vincent Individual Corporate OfficerAssistant Secretary Dec 9, 2021
Nika Hosseini Individual Corporate DirectorDirector Apr 4, 2024
James Arocho Individual Corporate DirectorDirector Sep 11, 2014
Todd a Goodman Individual Corporate OfficerAssistant Secretary Sep 14, 2017
Corporate DirectorDirector Feb 23, 2017
David R Sinclair Individual Contracted Managing EmployeeCeo Mar 9, 2025
Corporate OfficerCeo Mar 9, 2025
Operational/Managerial ControlCeo Mar 9, 2025
David L Huffman Individual Corporate OfficerAssistant Secretary Feb 27, 2020
Julie L Turpin Individual Corporate DirectorDirector Aug 21, 2025
Robert C Foltz Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Feb 5, 2002
Randall Haffner Individual Corporate DirectorDirector Apr 8, 2021
Utpal Sureskumar Desai Individual Corporate DirectorDirector Jan 1, 2025
John P Ferguson Individual Corporate DirectorDirector Jun 8, 2017
Beverly Morgan Individual Corporate OfficerAsst Secretary Aug 21, 2025
Adventist Health System Sunbelt Inc Organization, Altamonte Springs, FL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2000 100%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Adventhealth Palm CoastPalm Coast, FL, CCN 100118 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1991
Adventhealth DelandDeland, FL, CCN 100045 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 28, 1994
Adventhealth DelandDeland, FL, CCN 10S045 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 28, 1994

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 88

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

View all 88

Practitioners & affiliated clinicians

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1598860108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W GRANADA BLVD STE 203",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745179",
            "telephone_number": "386-231-4610",
            "fax_number": "386-231-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175167",
            "telephone_number": "386-231-6000",
            "fax_number": "386-231-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HEALTH SYSTEMS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH SYSTEMS INC FLORIDA HOSPITAL ORMOND MEMORIAL",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "DOMAYER",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "386-231-3906"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "FL",
            "license": "4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AdventHealth Daytona Beach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Oceanside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.