Memorial Hospital
Organization Active NPI Family Medicine Physician · North Conway, NH
NPI 1992000103 · NPPES record last updated Aug 8, 2024
Key facts
- NPI
- 1992000103
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- MEMORIAL HOSPITAL
- Practice address
- 3073 White Mountain Hwy
North Conway, NH 03860-7101 - Phone
- (603) 356-5461
- Fax
- (603) 356-5877
- NPI assigned
- Jan 19, 2011
- Organization subpart
- No
Authorized official
- Name
- Diana J McLaughlin
- Title
- Chief Financial Officer
- Phone
- (603) 356-0613
Owners & managing parties with NPI records 1
-
Mary A. Vigeant, ARNP
Other NPIs on the same Medicare enrollment 4
Related certifications (CCN) 2
Practitioners 119
-
Robin Max Abeles, PA-C
-
Jessica Anne Bacon, CNM
-
Nicole Maher Becker, PA-C
-
Marc Daigle, M.D.
-
Heidi Ann Darling, APRN
-
Erik Davitt, M.D.
-
Maria Michelle Diaz, M.D.
-
Erik Doty, DO
-
Suzanne C Evans, FNP-BC
-
Gregory Galvin, DO
-
Anna J Goodkin, CRNA
-
Jill D Goss, APRN, FNP-BC
-
Kiersten L Gurley, M.D.
-
Jacob Hibbert, CRNA
-
Charisse N. Hirschfeld, ARNP
-
David D Hoeft, DPM
-
Emily Husson, MD
-
Melissa Kanter, APRN
-
Ghaleb M Karouni, MD
-
Jennifer Anne Labudde, M.D.
-
Sarah Ashley Lacey, FNP-BC
Affiliated clinicians 389
-
Sonya W Alyea, APRN
-
Michael Angus Badger, M.D.
-
Emily Beaulieu, ARNP
-
Nicole Maher Becker, PA-C
-
Judith A Brewster, PA-C
-
Andrew L Chen, M.D., M.S.
-
Leona S Cloutier, APRN
-
Deborah Ann Cross, ARNP
-
Ashley Cyr, CRNA, DNP
-
Marc Daigle, M.D.
-
Kelly Catherine Defeo, CRNA , APRN, PHD
-
Morice P. Dennery, M.D.
-
Sarah Ann Duplinsky, FNP
-
Brady Alan Edge, PA-C
-
Chelsea Michelle Ela, APRN
-
Jennie Emery, D.O.
-
David Kent Esmay, CRNA
-
Dustin Gregory Forrest, APRN
Medicare Care Compare: Hospital
- Listed as
- Memorial Hospital, the
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NH
Hospital certification: CCN 301307
- Legal name
- MEMORIAL HOSPITAL
- Doing business as
- MAINEHEALTH MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Oct 18, 2004
- Last certification
- Sep 29, 2022
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 30, 1910 in NH
- Enrollment address
- 3073 White Mountain Hwy
North Conway, NH 38607101
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Dawn M Tutt |
W-2 Managing Employee |
Jun 23, 2021 | |
| Corinne Ray |
Corporate Officer |
Dec 1, 2021 | |
| Corporate Director | Jan 1, 2018 | ||
| Andrew T Mueller |
Corporate Director | Apr 19, 2021 | |
| Diana J McLaughlin |
Corporate Officer |
Mar 1, 2020 | |
| W-2 Managing Employee |
Jul 1, 2016 | ||
| Tricia Costigan |
Corporate Officer | Feb 17, 2025 | |
| W-2 Managing Employee |
Feb 17, 2025 | ||
| Christopher C Perley |
Corporate Officer |
Dec 1, 2021 | |
| Corporate Director | Dec 1, 2020 | ||
| Rachael R Brown |
Corporate Director | May 1, 2024 | |
| Christine Thompson |
Corporate Director | May 1, 2024 | |
| Mainehealth Services |
5% Or Greater Direct Ownership Interest | Jan 1, 2014 | 100% |
| Linda M. Terry |
Corporate Officer |
Dec 1, 2021 | |
| Corporate Director | Aug 1, 2019 | ||
| Donna Jauregui |
W-2 Managing Employee |
Aug 2, 2025 | |
| Theresa Struble |
W-2 Managing Employee |
Jan 6, 2025 | |
| Timothy G. Scott |
Corporate Director | Dec 1, 2019 | |
| Stephen J Boyle |
Corporate Director | Dec 1, 2021 | |
| Mary a Vigeant |
Corporate Director |
Jul 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040907000095 | NH | Part B Supplier - Clinic/Group Practice | 2365418993 |
Receives reassigned benefits from 176 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: North Conway, NH |
| O20061104000389 | NH | Part a Provider - Critical Access Hospital | 2365418993 |
Receives reassigned benefits from 175 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: North Conway, NH |
National Provider Directory
Locations
16 Fahy St
Ste 201
Belfast, ME 04915
Phone (207) 505-4491
116 Northport Ave
Ste 214
Belfast, ME 04915
Phone (207) 505-4398
9 Healthcare Dr
Ste 112
Biddeford, ME 04005
121 Medical Center Dr
Ste 2500
Brunswick, ME 04011
Phone (207) 373-6155
27 Watson Dr
Brunswick, ME 04011
181 Franklin Health Cmns
#2
Farmington, ME 04938
99 Campus Ave
Lewiston, ME 04240
Phone (207) 777-4455
25 June St
Ste 12
Sanford, ME 04073
25 June St
#A
Sanford, ME 04073
Phone (207) 324-8311
149 North St
Unit 8B
Waterville, ME 04901
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Hematology & Oncology Physician |
207RH0003X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Surgery Physician |
208600000X | |||
| Urology Physician |
208800000X | |||
| Hospitalist Physician |
208M00000X |
Addresses
Primary practice location
3073 White Mountain Hwy
North Conway, NH 03860-7101
Mailing address
PO Box 360558
Pittsburgh, PA 15251-6558
Phone (603) 356-5461
Other practice location 1
3107 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-7061
Other names
- MaineHealth Memorial Hospital
- Physicians at Memorial Hospital
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in North Conway, NH
- Memorial Elder Health Services
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Memorial Hospital
- Karen Merritt
- Amy Meunier
- Cynthia Montanez
- Shawna Ashley Moore
- Mountain Psychology & Wellness PLLC
All providers in North Conway, NH · Family Medicine Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.