ADVENTHEALTH MEDICAL GROUP – NPI #1275640997
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

ADVENTHEALTH MEDICAL GROUP is a provider located in PALM COAST, FL. NPPES has assigned the NPI number 1275640997 to ADVENTHEALTH MEDICAL GROUP on August 25, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ADVENTHEALTH MEDICAL GROUP” is a dba name, the actual legal business name for this organization is MEMORIAL HEALTH SYSTEMS INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 5 years ago on Feb 26, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ADVENTHEALTH MEDICAL GROUP below.

NPI Profile for
MEMORIAL HEALTH SYSTEMS INC

NPI Number
1275640997
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MEMORIAL HEALTH SYSTEMS INC
Doing Business As (dba): ADVENTHEALTH MEDICAL GROUP
Primary location
61 MEMORIAL MEDICAL PKWY STE 2811
PALM COAST, FL 32164-5999
Phone: (386) 671-4519 Fax:
1 Other location(s):
875 Sterthaus Ave
Ormond Beach, FL 32174-5131
Phone: (386) 671-4500
Fax: (386) 672-9904
Mailing address
PO BOX 730729
ORMOND BEACH, FL 32173-0729
Phone: (386) 671-4500 Fax: (386) 672-9904
Organization Subpart
No
Authorized Official
CORY DOMAYER
VP
Phone: (383) 231-3906
Updated
Certification Date
Feb 26, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)
363L00000X
- Nurse Practitioner
363A00000X
- Physician Assistant
207Q00000X
- Family Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.