MEMORIAL HOSPITAL ASSOCIATION NPI 1275979031

NPI Information

  • NPI: 1275979031
  • Provider Name: MEMORIAL HOSPITAL ASSOCIATION
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: MEMORIAL MEDICAL AUGUSTA CLINIC
  • CLIA Number: 14D2264211
  • Address: 204 CENTER ST
    AUGUSTA, IL
    ZIP 62311
  • Phone: (217) 392-2108

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NPI Details

MEMORIAL HOSPITAL ASSOCIATION is a family nurse practitioner in Augusta, IL. MEMORIAL HOSPITAL ASSOCIATION NPI is 1275979031. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Memorial Medical Augusta Clinic.

The provider's business location address is:

204 CENTER ST
AUGUSTA, IL
ZIP 62311-228
Phone: (217) 392-2108
Fax: (217) 392-2110

The provider's authorized official is Jessie Fifer .
The authorized official title is Special Projects Coordinator and has the following contact phone number (217) 357-6594.

The CLIA number assigned to this NPI record is 14D2264211 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2013 and was last updated on 5/20/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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