NPIMap

Organization Active NPI

Memorial Hospital, Inc.

  • Skilled Nursing Facility
  • Neillsville, WI
National Provider Identifier
1992780464
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MEMORIAL HOSPITAL, INC.
Practice address
216 Sunset Place
Memorial Medical Center Health & Rehabilitation
Neillsville, WI 54456
Phone
(715) 743-3101
Fax
(715) 743-6245
NPI assigned
Dec 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Scott Polenz
Title
Administrator
Phone
(715) 743-3101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

216 Sunset Place
Memorial Medical Center Health & Rehabilitation
Neillsville, WI 54456

Mailing address

216 Sunset Place
Memorial Medical Center Health & Rehabilitation
Neillsville, WI 54456
Phone (715) 743-3101

Other identifiers 1

IdentifierTypeStateIssuer
20128600MedicaidWI

Other names 1

  • Memorial Medical Center & Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Memorial Medical Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1992780464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SUNSET PLACE",
            "address_2": "MEMORIAL MEDICAL CENTER HEALTH & REHABILITATION",
            "city": "NEILLSVILLE",
            "state": "WI",
            "postal_code": "54456",
            "telephone_number": "715-743-3101",
            "fax_number": "715-743-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SUNSET PLACE",
            "address_2": "MEMORIAL MEDICAL CENTER HEALTH & REHABILITATION",
            "city": "NEILLSVILLE",
            "state": "WI",
            "postal_code": "54456",
            "telephone_number": "715-743-3101",
            "fax_number": "715-743-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "POLENZ",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-743-3101"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20128600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neillsville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.