NPIMap

Organization Active NPI

Memorial Home Services

  • Home Health Agency
  • Springfield, IL
National Provider Identifier
1982607123
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1002377 Issued in IL
Legal business name
MEMORIAL HOME SERVICES
Practice address
701 N 1St St
Springfield, IL 62781-4952
Phone
(217) 788-4663
Fax
(217) 788-5557
NPI assigned
May 23, 2005
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Christina Ann King, RN, BSN
Title
Director- Home Health
Phone
(217) 788-4663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1002377 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62781-4952

Mailing address

701 N 1St St
Springfield, IL 62781-4952
Phone (217) 788-4663

Other practice location 1

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 788-4663

Other names 1

  • Memorial Home Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080604000272 IL Part A Provider - Home Health Agency 8527069715 Practice locations: Decatur, IL; Springfield, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982607123. Details of each certification follow.

Home health agency certification: CCN 147003

Legal name
MEMORIAL HOME SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Jan 28, 2020
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Feb 21, 1916 in IL
Enrollment address
701 North First Street, Mailbox 15
Springfield, IL 62781

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Memorial Home ServicesCCN 147003 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Jul 1, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Member of 1

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

Locations

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly L Bourne Individual Corporate Director Feb 20, 2020
Tamar Kutz Individual Corporate Director Feb 20, 2020
Jameson Roszhart Individual Corporate Officer Feb 20, 2020
Kevin R England Individual Corporate Director Jan 1, 2009
Michael T Huffman Individual Corporate Director Jan 1, 2025
Dolan Dalpoas Individual Corporate Director Jan 1, 2009
Kathryn J Keim Individual Corporate Officer Feb 20, 2020
Memorial Home Services Organization, Springfield, IL Non-profit 5% Or Greater Direct Ownership Interest Jun 13, 1984
Henry Hurwitz Individual Corporate Officer Jan 1, 2025
Christina King Individual Corporate DirectorDir Dec 31, 2018
Operational/Managerial ControlDir Dec 31, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1982607123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627814952",
            "telephone_number": "217-788-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627814952",
            "telephone_number": "217-788-4663",
            "fax_number": "217-788-5557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 N Edward St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264163",
            "country_code": "US",
            "telephone_number": "217-788-4663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEMORIAL HOME SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR- HOME HEALTH",
        "authorized_official_telephone_number": "217-788-4663",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1002377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Home Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.