Memorial Hospital, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

00000000-16 Issued in TN

Legal business name

MEMORIAL HOSPITAL, INC.

Practice address

149 Health Care LN
Jellico, TN 37762-4433

Phone

(423) 784-2452

Fax

(423) 784-1184

NPI assigned

Jul 9, 2006

Organization subpart

Yes

Parent organization

MEMORIAL HOSPITAL, INC.As reported in NPPES

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

Authorized official

Name

Paul Merklin

Title

Chief Financial Officer

Phone

(606) 598-1035

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• Sunbelt Homecare Doing business as

Part of

Red Bird Clinic

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Memorial Hospital, Inc.

  • Family Medicine Physician
  • Manchester, KY
  • NPI 1598166092

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1902839293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 HEALTH CARE LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624433",
            "telephone_number": "423-784-1206",
            "fax_number": "423-784-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HEALTH CARE LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624433",
            "telephone_number": "423-784-2452",
            "fax_number": "423-784-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2006-07-09",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "MERKLIN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "606-598-1035"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "00000000-16",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH",
            "identifier": "0447492",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP COMPANIES",
            "identifier": "100020437",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "46166",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE MCR",
            "identifier": "0447492",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE",
            "identifier": "3075983",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE SELECT",
            "identifier": "3075983",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING LIFE MCR",
            "identifier": "0447492",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE TENNCARE",
            "identifier": "0447492",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "087482900",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunbelt Homecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sunbelt Homecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Jellico, TN
• Home Health Agency in Tennessee

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.