NPIMap

Organization Active NPI

Methodist Healthcare - Memphis Hospitals

Doing business as Le Bonheur Children's Hospital - Germantown

  • Children's Hospital
  • Germantown, TN
National Provider Identifier
1649654450
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
0000000109 Issued in TN
Legal business name
METHODIST HEALTHCARE - MEMPHIS HOSPITALS
Doing business as
Le Bonheur Children's Hospital - Germantown
Practice address
7691 Poplar Ave
Germantown, TN 38138-3904
Phone
(901) 516-6000
NPI assigned
Jul 13, 2015
Last updated
Jul 13, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST LE BONHEUR HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Chris McLean
Title
Chief Financial Officer
Phone
(901) 516-0753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 0000000109 TN Primary

Addresses

Primary practice location

7691 Poplar Ave
Germantown, TN 38138-3904

Mailing address

1211 Union Ave Ste 700
Memphis, TN 38104-6600

Other identifiers 1

IdentifierTypeStateIssuer
0440049MedicaidTN

Other names 1

  • Le Bonheur Children's Hospital - Germantown Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080506000320 TN Part A Provider - Hospital 1355248394 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649654450. Details of each certification follow.

Hospital certification: CCN 440049

Legal name
METHODIST HEALTHCARE - MEMPHIS HOSPITALS
Doing business as
METHODIST HOSPITALS OF MEMPHIS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 21, 1997
Beds
1,593
Ownership / control type
Church
Organization structure
OtherNon-profit
Incorporated
Jul 1, 1966 in TN
Enrollment address
1265 Union Avenue
Methodist University Hospital
Memphis, TN 38104
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Children’s

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

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
Methodist Hospitals of MemphisCCN 440049 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Methodist Hospital Cent12 organizations share this tax ID, including this one
Part of
Methodist Healthcare

Other organizations with this tax ID 11

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

Locations

1211 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 287-5182

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Michael Ugwueke Individual Corporate OfficerMethodist Healthcare - Memphis H May 1, 2014
Larry M Fogarty Individual Corporate OfficerInterim Cfo Jan 1, 2000
W-2 Managing EmployeeInterim Cfo Jan 1, 2000
Methodist Le Bonheur Healthcare Organization, Memphis, TN 5% Or Greater Direct Ownership Interest May 1, 2008

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 1,636

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

View all 1,636

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1649654450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 700",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383904",
            "telephone_number": "901-516-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HEALTHCARE - MEMPHIS HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST LE BONHEUR HEALTHCARE",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "MCLEAN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "901-516-0753"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "TN",
            "license": "0000000109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440049",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Le Bonheur Children's Hospital - Germantown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.