Memorial Hospital
Organization Active NPI General Practice Physician · Owosso, MI
NPI 1609030600 · NPPES record last updated Dec 9, 2024
Key facts
- NPI
- 1609030600
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- MEMORIAL HOSPITAL
- Practice address
- 1002 E M 21 Ste 100
Owosso, MI 48867-9007 - Phone
- (989) 720-5400
- Fax
- (989) 729-4303
- NPI assigned
- Jul 18, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- MEMORIAL HOSPITAL
Authorized official
- Name
- Jorri M Tremain
- Title
- Cfo
- Phone
- (989) 729-4466
Other NPIs on the same Medicare enrollment 6
Practitioners 21
-
Mandell Tony Bookman, M.D.
-
Jimmy Qaqish, MD
-
Amanda Brooke Ariss, FNP
-
Jennifer M Dowd, FNP
-
Tiffini Lynn Esch, FNP-C
-
Barbara A Gurden, DO
-
Diane L Gutchak, DNP
-
Krisha Horger, NP
-
Meredith M Lovasz, FNP
-
Whitney Nicole Malzahn, NURSE PRACTITIONER
-
Erin Rice, FNP-C
-
Amber Rae Righi, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040122000907 | MI | Part B Supplier - Clinic/Group Practice | 8527976497 |
Receives reassigned benefits from 363 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Owosso, MI; Perry, MI; Saginaw, MI; Saint Johns, MI; Howell, MI; Ovid, MI; Okemos, MI; Laingsburg, MI… |
National Provider Directory
- Part of
- The Memorial Hospital
Locations
9099 E Lansing Rd
Ste A
Durand, MI 48429
Phone (989) 288-2651
9099 E Lansing Rd
Ste B
Durand, MI 48429
Phone (989) 288-0400
818 W King St
Ste Ll
Owosso, MI 48867
Phone (989) 729-4292
239 N State Rd
Ste 102
Owosso, MI 48867
Phone (989) 720-5400
239 N State Rd
Owosso, MI 48867
Phone (989) 743-3415
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
1002 E M 21 Ste 100
Owosso, MI 48867-9007
Mailing address
113 E Williams St
Owosso, MI 48867-2360
Phone (989) 725-6528
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609030600 | Medicaid | MI |
Other names
- Memorial Healthcare
Other providers in Owosso, MI
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
All providers in Owosso, MI · General Practice Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.