Active NPI
Memorial Hospital, Inc.
- Pediatrics Physician
- Manchester, KY
National Provider Identifier
1902208267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- MEMORIAL HOSPITAL, INC.
- Practice address
- 94 Marie Langdon Dr
Suite 1
Manchester, KY 40962-6353 - Phone
- (606) 599-0396
- Fax
- (606) 599-0586
- NPI assigned
- Sep 18, 2014
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Connie Farmer
- Title
- Billing Manager
- Phone
- (606) 598-5104
Other NPIs on the same Medicare enrollment 20
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Diagnostic Radiology Physician
- Manchester, KY
- NPI 1649573692
O20041103001183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041103001183 | KY | Part B Supplier - Clinic/Group Practice | 4486616141 |
Receives reassigned benefits from 129 practitioners 20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Pineville, KY; Somerset, KY; Oneida, KY; MC Kee, KY; Manchester, KY; London, KY; Corbin, KY; Beverly, KY |
National Provider Directory
National Provider DirectorySpecialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
94 Marie Langdon Dr
Suite 1
Manchester, KY 40962-6353
Mailing address
509 Memorial Dr
Suite 2
Manchester, KY 40962-6195
Phone (606) 598-5104
Other names 1
NPPES NPI Registry- Manchester Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 13, 2021.
{
"created_epoch": "1410998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1610496000000",
"number": "1902208267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 MEMORIAL DR",
"address_2": "SUITE 2",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409626195",
"telephone_number": "606-598-5104",
"fax_number": "606-598-0983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 MARIE LANGDON DR",
"address_2": "SUITE 1",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409626353",
"telephone_number": "606-599-0396",
"fax_number": "606-599-0586"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEMORIAL HOSPITAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-18",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A",
"authorized_official_last_name": "FARMER",
"authorized_official_first_name": "CONNIE",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "606-598-5104"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Manchester Pediatrics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Manchester Pediatrics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Manchester, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.