NPIMap

Organization Active NPI

Memorial Hospital Flagler Inc

Doing business as AdventHealth Palm Coast

  • General Acute Care Hospital
  • Palm Coast, FL
National Provider Identifier
1679678486
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
4465 Issued in FL
Legal business name
MEMORIAL HOSPITAL FLAGLER INC
Doing business as
AdventHealth Palm Coast
Florida Hospital Flagler
Practice address
60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone
(386) 586-2000
NPI assigned
Sep 14, 2006
Last updated
Aug 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Authorized official

Name
Mr. Mark Rathbun
Title
Chief Financial Officer
Phone
(386) 586-4301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 4465 FL Primary

Addresses

Primary practice location

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980

Mailing address

770 W Granada Blvd Ste 203
Ormond Beach, FL 32174-5179
Phone (386) 312-4252

Other identifiers 5

IdentifierTypeStateIssuer
5000093OtherFLUHC
59387OtherFLAETNA HMO
6200175OtherFLAETNA PPO
323OtherFLBLUE CROSS
010189300MedicaidFL

Other names 2

  • AdventHealth Palm Coast Doing business as
  • Florida Hospital Flagler Doing business as

Electronic endpoints 2

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

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040922000189 FL Part A Provider - Hospital 1759371594 Practice locations: Palm Coast, FL; Saint Augustine, FL
O20251021001736 FL Part B Supplier - Intensive Cardiac Rehabilitation 1759371594 Practice locations: Palm Coast, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679678486. Details of each certification follow.

Hospital certification: CCN 100118

Legal name
MEMORIAL HOSPITAL FLAGLER INC
Doing business as
ADVENTHEALTH PALM COAST
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 1, 1980
Last certification
Jul 30, 2021
Beds
99
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
May 31, 1989 in FL
Enrollment address
60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
AdventHealth Palm CoastCCN 100118 · All quality measures
Overall star rating
5 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
Florida Hospital Healthcare Partners Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 41)

703 E Moody Blvd
Bunnell, FL 32110
Phone (386) 437-3091

901 E Moody Blvd
Bunnell, FL 32110

201 Hilda St
Ste 20
Kissimmee, FL 34741
Phone (407) 944-3104

264 S Atlantic Ave
Ormond Beach, FL 32176
Phone (386) 672-4161

770 W Granada Blvd
Ste 304
Ormond Beach, FL 32174
Phone (386) 231-5298

770 W Granada Blvd
Ste 319
Ormond Beach, FL 32174
Phone (386) 673-3121

1 Memorial Medical Pkwy
Ste 100
Palm Coast, FL 32164
Phone (386) 586-2060

120 Cypress Edge Dr
Ste 101
Palm Coast, FL 32164
Phone (386) 586-1670

120 Cypress Edge Dr
Ste 103
Palm Coast, FL 32164
Phone (386) 586-1650

120 Cypress Edge Dr
Ste 120
Palm Coast, FL 32164
Phone (386) 586-4200

120 Cypress Edge Dr
Ste 204
Palm Coast, FL 32164
Phone (386) 586-4428

120 Cypress Edge Dr
Ste 206
Palm Coast, FL 32164
Phone (386) 586-4464

120 Cypress Edge Dr
Ste 207
Palm Coast, FL 32164
Phone (386) 586-1910

120 Cypress Edge Dr
Ste 210
Palm Coast, FL 32164
Phone (386) 445-4750

120 Pinnacles Dr
Ste 1
Palm Coast, FL 32164
Phone (386) 231-6549

13 Kingswood Dr
#B
Palm Coast, FL 32137

150 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (386) 586-4600

21 Hospital Dr
Ste 120A
Palm Coast, FL 32164
Phone (386) 586-4280

21 Hospital Dr
Ste 120B
Palm Coast, FL 32164
Phone (386) 586-4280

21 Hospital Dr
Ste 290
Palm Coast, FL 32164
Phone (386) 317-8640

3 Adventhealth Way
#201
Palm Coast, FL 32137

3 Adventhealth Way
#210
Palm Coast, FL 32137

3 Adventhealth Way
Ste 110
Palm Coast, FL 32137
Phone (386) 586-2453

3 Adventhealth Way
Ste 130
Palm Coast, FL 32137
Phone (386) 586-1930

3 Adventhealth Way
Ste 201
Palm Coast, FL 32137
Phone (386) 586-1840

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
Richard V Cashio Individual Corporate DirectorDirector Dec 12, 2024
Jessica Brazier Individual Corporate DirectorDirector Jun 10, 2023
Michele Goeb-Burkett Individual Corporate DirectorDirector Jun 10, 2023
Debora H Thomas Individual Corporate OfficerSecretary, Assistant Secretary Aug 24, 2023
Corporate DirectorDirector Aug 24, 2023
Douglas Hilliard Individual Corporate OfficerAssistant Secretary Aug 21, 2025
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Sep 1, 2019
Diane Godfrey Individual Corporate OfficerAssistant Secretary Dec 11, 2025
Mark Rathbun Individual Contracted Managing EmployeeChief Financial Officer Aug 17, 2020
Corporate OfficerTreasurer Apr 8, 2021
Operational/Managerial ControlChief Financial Officer Aug 17, 2020
Robert Deininger Individual Corporate OfficerAssistant Secretary, Chair Aug 21, 2025
Corporate DirectorDirector Jun 13, 2025
Kari Vargas Individual Corporate DirectorDirector Dec 12, 2024
Laura Gilvary Individual Corporate DirectorDirector Apr 4, 2024
Michael Chiumento Individual Corporate DirectorDirector Dec 12, 2024
Marisa Farabaugh Individual Corporate OfficerAssistant Secretary Apr 9, 2026
Michael Saunders Individual Corporate OfficerAssistant Secretary Sep 1, 2019
Ellen Wahl Individual Corporate DirectorDirector Dec 11, 2025
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%
Tanam S Ahmed Individual Corporate DirectorDirector Jan 1, 2026
Amanda Brady Individual Corporate OfficerAssistant Secretary Aug 25, 2022
Toni Berrios Individual Corporate OfficerAssistant Secretary Aug 25, 2022
Haney Vincent Individual Corporate OfficerAssistant Secretary Dec 9, 2021
Douglas Pytlinski Individual Corporate OfficerAssistant Secretary Apr 9, 2026
Todd a Goodman Individual Corporate OfficerAssistant Secretary Sep 14, 2019
Lorenzo Brown Individual Corporate OfficerVice Chair Apr 9, 2026
Corporate DirectorDirector Apr 9, 2026
David L Huffman Individual Corporate OfficerAssistant Secretary Feb 27, 2020
Robert C Foltz Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Daniel T McDermott Individual Corporate DirectorDirector Dec 12, 2024
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Sep 1, 2019
Walmir de Aquino Individual Corporate OfficerVice Chair Dec 11, 2025
Corporate DirectorDirector Jun 10, 2023
Randall Haffner Individual Corporate OfficerAssistant Secretary Apr 8, 2021
Corporate DirectorDirector Apr 8, 2021
Memorial Health Systems Inc Organization, Daytona Beach, FL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 1991 100%
Denyse Bales-Chubb Individual Contracted Managing EmployeeChief Executive Officer Jun 19, 2022
Corporate OfficerSecretary, President Jul 21, 2022
Corporate DirectorDirector Jun 10, 2023
Operational/Managerial ControlChief Executive Officer Jun 19, 2022
Alvin B Jackson Individual Corporate DirectorDirector Dec 11, 2025
Beverly Morgan Individual Corporate OfficerAssistant 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 Indirect 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.

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

Practitioners 116

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 116

Affiliated clinicians 771

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

View all 771

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": "1723075200000",
    "number": "1679678486",
    "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": "386-312-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MEMORIAL MEDICAL PKWY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645980",
            "telephone_number": "386-586-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL FLAGLER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "RATHBUN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "386-586-4301",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "4465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "5000093",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "59387",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "6200175",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "323",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010189300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "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"
        },
        {
            "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"
        }
    ],
    "other_names": [
        {
            "organization_name": "AdventHealth Palm Coast",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Flagler",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.