Memorial Hospital Flagler Inc

Primary specialty

Cardiac Rehabilitation Clinic/CenterTaxonomy code 261QR0404X

Legal business name

MEMORIAL HOSPITAL FLAGLER INC

Practice address

60 Memorial Medical Pkwy Ste 500
Palm Coast, FL 32164-5980

Phone

(386) 586-4200

NPI assigned

Jan 18, 2022

Organization subpart

Yes

Parent organization

MEMORIAL HOSPITAL FLAGLER INCAs reported in NPPES

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

Authorized official

Name

Mark Rathbun

Title

Cfo

Phone

(386) 586-4301

Specialties & licenses 1

Addresses

Other names 2

• ADVENTHEALTH PALM COAST Doing business as
• FLORIDA HOSPITAL FLAGLER Doing business as

Electronic endpoints 1

Tax ID family

Adventhealth Medical Group2 organizations share this tax ID, including this one

Part of

Adventhealth Medical Group

Other organizations with this tax ID 1

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

• Florida Hospital Flagler

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1851789747
  NPD tax ID

Locations

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1689325938",
    "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": "386-231-4252",
            "fax_number": "386-676-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MEMORIAL MEDICAL PKWY STE 500",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645980",
            "telephone_number": "386-586-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL FLAGLER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOSPITAL FLAGLER INC",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-08-12",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "RATHBUN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "386-586-4301"
    },
    "taxonomies": [
        {
            "code": "261QR0404X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Cardiac Facilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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"
        }
    ],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH PALM COAST",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FLORIDA HOSPITAL FLAGLER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lacy Lynn Melton, M.S.
• Amos Melvin Jr., BC-HIS
• Memorial Health Systems Inc
• Memorial Hospital Flagler Inc
• Memorial Hospital Flagler Inc
• Memorial Hospital Flagler Inc.
• Bryan Mendes, PT, DPT
• Erica A Mendes
• Antonio Mendez
• Jonathan F Mendoza

• All providers in Palm Coast, FL
• Cardiac Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.