NPIMap

Organization Active NPI

Memorial Community Health, Inc

Doing business as Memorial Health Clinic

  • Family Medicine Physician
  • Aurora, NE
National Provider Identifier
1881603850
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEMORIAL COMMUNITY HEALTH, INC
Doing business as
Memorial Health Clinic
Practice address
609 O St
Aurora, NE 68818-1100
Phone
(402) 694-3191
Fax
(402) 694-2146
NPI assigned
Aug 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Phil Fendt
Title
Chief Financial Officer
Phone
(402) 694-6007

Specialties & licenses 1

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

Addresses

Primary practice location

609 O St
Aurora, NE 68818-1100

Mailing address

609 O St
Aurora, NE 68818-1100
Phone (402) 694-3191

Other names 1

  • MEMORIAL HEALTH CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100213000119 NE Part B Supplier - Clinic/Group Practice 1355394040 Receives reassigned benefits from 35 practitioners
Practice locations: Aurora, NE; Harvard, NE; Clay Center, NE

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory

Locations

319 W Glenvil St
Clay Center, NE 68933
Phone (402) 762-3236

Interoperability endpoints

  • Direct secure messaging: clinicdirect@mchi.cernerdirect.com
  • Direct secure messaging: hollysolt@mchi.cernerdirect.com

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881603850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 O ST",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688181100",
            "telephone_number": "402-694-3191",
            "fax_number": "402-694-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 O ST",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688181100",
            "telephone_number": "402-694-3191",
            "fax_number": "402-694-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL COMMUNITY HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FENDT",
        "authorized_official_first_name": "PHIL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "402-694-6007"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEMORIAL HEALTH CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.