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MEMORIAL MANOR NURSING HOME
NPI 1114920584
Skilled Nursing Facility in Pembroke Pines, FL

Active since May 31, 2005CLIA 10D0278192 · Waiver
777 S DOUGLAS RD, PEMBROKE PINES, FL 33025(954) 431-1100(954) 443-4798 Get Directions Write a Review

NPPES record last updated: January 23, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Memorial Manor Nursing Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORIAL MANOR NURSING HOME (NPI 1114920584) is a healthcare organization registered as a skilled nursing facility in Pembroke Pines, Florida and active in the NPI registry since May 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jon Hennemyre, Administrator, as its authorized official.

NPPES Registry Identity

NPI1114920584
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameSOUTH BROWARD HOSPITAL DISTRICT
Location Address777 S DOUGLAS RDPembroke Pines, FL 33025-1353
Mailing Address777 S Douglas RdPembroke Pines, FL 33025-1353 · (954) 431-1100 · Fax (954) 443-4798
Phone(954) 431-1100
Fax(954) 443-4798
Organization SubpartNo
Authorized OfficialJon HennemyreAdministrator · (954) 276-6201
Enumeration DateMay 31, 2005
Last NPPES UpdateJanuary 23, 2019
✔ NPI 1114920584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in FL · SNF1342096
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
777 S DOUGLAS RD, Pembroke Pines, FL 33025
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Other Names 2

Doing Business AsMemorial Manor Nursing Home
Doing Business AsMemorial Manor

Other Identifiers 1

Medicaid020100600FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next and more.Insurance ›

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 10D0278192

Memorial Manor · Pembroke Pines, FL
Active · expires Aug 31, 2026
CLIA Number10D0278192
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJon Hennemyre
Laboratory Phone(954) 276-6201
Laboratory LocationMemorial Manor777 S Douglas Rd, Pembroke Pines, FL 33025
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASNIELKA VALDEZ MS, OTR/L
Occupational Therapist
777 S DOUGLAS RD
PEMBROKE PINES, FL 33025
Broward County (954) 276-6280
SOUTH BROWARD HOSPITAL DISTRICT
Pharmacy (Long Term Care Pharmacy)
777 S DOUGLAS RD
PEMBROKE PINES, FL 33025
Broward County (954) 518-5670
MICHELLE WOODBINE
Physical Therapy Assistant
777 S DOUGLAS RD
PEMBROKE PINES, FL 33025
Broward County (954) 276-6244

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 South Broward Hospital District's NPI number?

The NPI number for South Broward Hospital District is 1114920584. It was assigned to this organization in the NPPES registry on May 31, 2005. The provider is doing business as Memorial Manor Nursing Home and Memorial Manor.

Where is South Broward Hospital District located?

South Broward Hospital District is located at 777 S Douglas Rd, Pembroke Pines, FL 33025. The listed phone number is (954) 431-1100.

What is South Broward Hospital District's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does South Broward Hospital District hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0278192) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does South Broward Hospital District accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, AvMed and Oscar Health Maintenance Organization of Florida and 1 other insurer list South Broward Hospital District as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Broward Hospital District was last updated on January 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.