NPIMap

Organization Active NPI

Memorial Management Inc

  • Family Medicine Physician
  • Marion, IL
National Provider Identifier
1720087950
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEMORIAL MANAGEMENT INC
Practice address
3331 W Deyoung St
Suite 105
Marion, IL 62959-5896
Phone
(618) 997-9496
NPI assigned
Jul 19, 2005
Last updated
Jul 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Laura J Fey
Title
Sr. Director Physician Rev Cycle
Phone
(615) 221-3641

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Urology Physician 208800000X NU

Addresses

Primary practice location

3331 W Deyoung St
Suite 105
Marion, IL 62959-5896

Mailing address

1573 Mallory LN Ste 100
Brentwood, TN 37027-2895
Phone (152) 221-1400

National Provider Directory

National Provider Directory

Locations

3331 W Deyoung St
Ste 102
Marion, IL 62959
Phone (618) 998-7019

3331 W Deyoung St
Ste 205
Marion, IL 62959
Phone (618) 233-5722

903 W Main St
Marion, IL 62959
Phone (618) 993-0557

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1720087950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 MALLORY LN STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272895",
            "telephone_number": "152-221-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 W DEYOUNG ST",
            "address_2": "SUITE 105",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595896",
            "telephone_number": "618-997-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.