NPIMap

Organization Active NPI

Massac Memorial Hospital

  • Ambulance
  • Metropolis, IL
National Provider Identifier
1801941968
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
0001420 Issued in IL
Legal business name
MASSAC MEMORIAL HOSPITAL
Doing business as
Massac Memorial Hospital
Practice address
28 Chick St
Metropolis, IL 62960-2467
Phone
(618) 524-2176
Fax
(618) 524-4131
NPI assigned
Jan 25, 2007
Last updated
Aug 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
Mrs. Lynn Goines
Title
Chief Financial Officer
Phone
(618) 524-2176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 0001420 IL Primary

Addresses

Primary practice location

28 Chick St
Metropolis, IL 62960-2467

Mailing address

PO Box 850
28 Chick Street
Metropolis, IL 62960-0850
Phone (618) 524-2176

Other names 1

  • Massac Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180320001651 IL Part B Supplier - Ambulance Service Supplier 3072422799 Practice locations: Metropolis, IL

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Massac Memorial Hospital4 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.

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Massac Memorial HospitalMetropolis, IL, CCN 141323 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Oct 18, 2007
Oct 18, 2007
Massac Memorial HospitalMetropolis, IL, CCN 14Z323 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Feb 1, 2003
Feb 1, 2003
Massac Memorial Medical ClinicMetropolis, IL, CCN 143478 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Feb 1, 2006
Feb 1, 2006
Massac Memorial Integrated Care ClinicMetropolis, IL, CCN 148618 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2020

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1801941968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "address_2": "28 CHICK STREET",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629600850",
            "telephone_number": "618-524-2176",
            "fax_number": "618-524-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CHICK ST",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629602467",
            "telephone_number": "618-524-2176",
            "fax_number": "618-524-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSAC MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "GOINES",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "618-524-2176",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "0001420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Massac Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Massac Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metropolis, IL

Sources for this page

Verify at the official NPI Registry.