NPIMap

Organization Active NPI

Memorial Hospital

  • Critical Access Hospital
  • North Conway, NH
National Provider Identifier
1700864709
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
00009 Issued in NH
Legal business name
MEMORIAL HOSPITAL
Practice address
3073 White Mountain Hwy
North Conway, NH 03860
Phone
(603) 356-5461
NPI assigned
Jan 9, 2006
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
Diana J McLaughlin
Title
Chief Financial Officer
Phone
(603) 356-0613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 00009 NH Primary

Addresses

Primary practice location

3073 White Mountain Hwy
North Conway, NH 03860

Mailing address

PO Box 360558
Pittsburgh, PA 15251-6558
Phone (603) 356-5461

Other identifiers 1

IdentifierTypeStateIssuer
3074432MedicaidNH

Other names 1

  • MaineHealth Memorial Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040907000095 NH Part B Supplier - Clinic/Group Practice 2365418993 Receives reassigned benefits from 176 practitioners
4 other NPIs on this enrollment
Practice locations: North Conway, NH
O20061104000389 NH Part A Provider - Critical Access Hospital 2365418993 Receives reassigned benefits from 175 practitioners
4 other NPIs on this enrollment
Practice locations: North Conway, NH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Hospital certification: CCN 301307

Legal name
MEMORIAL HOSPITAL
Doing business as
MAINEHEALTH MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 18, 2004
Last certification
Sep 29, 2022
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 1910 in NH
Enrollment address
3073 White Mountain Hwy
North Conway, NH 38607101
Other Hospital Practice Location

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Locations

3073 White Mountain Hwy
Fl 1
North Conway, NH 03860

3073 White Mountain Hwy
Ste 1
North Conway, NH 03860

3073 White Mountain Hwy
#B
North Conway, NH 03860

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Dawn M Tutt Individual W-2 Managing EmployeeManager RCM Systems Support Jun 23, 2021
Corinne Ray Individual Corporate OfficerSecretary Dec 1, 2021
Corporate Director Jan 1, 2018
Andrew T Mueller Individual Corporate Director Apr 19, 2021
Diana J McLaughlin Individual Corporate OfficerChief Financial Officer Mar 1, 2020
W-2 Managing EmployeeChief Financial Officer Jul 1, 2016
Tricia Costigan Individual Corporate Officer Feb 17, 2025
W-2 Managing EmployeePresident Feb 17, 2025
Christopher C Perley Individual Corporate OfficerVice Chair Dec 1, 2021
Corporate Director Dec 1, 2020
Rachael R Brown Individual Corporate Director May 1, 2024
Christine Thompson Individual Corporate Director May 1, 2024
Mainehealth Services Organization, Portland, ME Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2014 100%
Linda M. Terry Individual Corporate OfficerTreasurer Dec 1, 2021
Corporate Director Aug 1, 2019
Donna Jauregui Individual W-2 Managing EmployeeDirector Provider Enrollment Cvo Aug 2, 2025
Theresa Struble Individual W-2 Managing EmployeeExecutive Assistant Jan 6, 2025
Timothy G. Scott Individual Corporate Director Dec 1, 2019
Stephen J Boyle Individual Corporate Director Dec 1, 2021
Mary a Vigeant Individual Corporate DirectorBoard Member Jul 1, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 29

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 29

Practitioners 217

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 217

Affiliated clinicians 389

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

View all 389

Care Compare: Hospital

Medicare Care Compare
Listed as
Memorial Hospital, theCCN 301307
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1700864709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360558",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152516558",
            "telephone_number": "603-356-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "03860",
            "telephone_number": "603-356-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "603-356-0613"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NH",
            "license": "00009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074432",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MaineHealth Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Conway, NH

Sources for this page

Verify at the official NPI Registry.