NPIMap

Organization Active NPI

Memorial Hospital

Doing business as Memorial Healthcare

  • General Practice Physician
  • Owosso, MI
National Provider Identifier
1609030600
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEMORIAL HOSPITAL
Doing business as
Memorial Healthcare
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
Last updated
Dec 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Jorri M Tremain
Title
Cfo
Phone
(989) 729-4466

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary
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 1

IdentifierTypeStateIssuer
1609030600MedicaidMI

Other names 1

  • Memorial Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Memorial Hospital

Locations

818 W King St
Ste Ll
Owosso, MI 48867
Phone (989) 729-4292

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1609030600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E WILLIAMS ST",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672360",
            "telephone_number": "989-725-6528",
            "fax_number": "989-723-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E M 21 STE 100",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679007",
            "telephone_number": "989-720-5400",
            "fax_number": "989-729-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOSPITAL",
        "enumeration_date": "2008-07-18",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "TREMAIN",
        "authorized_official_first_name": "JORRI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "989-729-4466"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609030600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owosso, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.