MEMORIAL PHYSICIAN SERVICES
NPI 1063961936
Nurse Practitioner - Family in Springfield, IL
About Memorial Physician Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEMORIAL PHYSICIAN SERVICES (NPI 1063961936) is a healthcare organization registered as a family in Springfield, Illinois and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through April 1, 2027 and lists Loralee Donnelly, Family Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 14D0926847
Memorial Physician Services - Koke Mill · Springfield, ILOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SPRINGFIELD, IL 62704
SPRINGFIELD, IL 62704
SPRINGFIELD, IL 62704
SPRINGFIELD, IL 62704
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Memorial Physician Services's NPI number?
The NPI number for Memorial Physician Services is 1063961936. It was assigned to this organization in the NPPES registry on October 3, 2016.
Where is Memorial Physician Services located?
Memorial Physician Services is located at 3132 Old Jacksonville Rd, Springfield, IL 62704. The listed phone number is (217) 862-0800.
What is Memorial Physician Services's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Memorial Physician Services hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D0926847) is associated with this NPI, valid through April 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Memorial Physician Services was last updated on October 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Memorial Physician Services · NPI 1063961936
Family organization in Springfield, Illinois. Organization record, active in the CMS NPPES registry since October 3, 2016.
## Identity
- **NPI:** 1063961936 (Entity type: Organization)
- **Enumerated:** October 3, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Loralee Donnelly, FAMILY NURSE PRACTITIONER
## Practice location
- **Address:** 3132 OLD JACKSONVILLE RD, Springfield, IL 62704-7400
- **Phone:** (217) 862-0800
## Record status
- **NPPES last updated:** October 3, 2016
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063961936) · Data from the CMS NPPES public registry.