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ADVENTHEALTH MEDICAL GROUP
NPI 1275640997
General Practice in Palm Coast, FL

Active since August 25, 2006CLIA Certified · 16 labs
61 MEMORIAL MEDICAL PKWY STE 2811, PALM COAST, FL 32164(386) 671-4519 Get Directions Write a Review

NPPES record last updated: February 26, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 26, 2021, Aug 5, 2019 (2 updates tracked since 2019).

About Adventhealth Medical Group NPPES

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

ADVENTHEALTH MEDICAL GROUP (NPI 1275640997) is a healthcare organization registered as a general practice in Palm Coast, Florida and active in the NPI registry since August 2006. The organization holds 16 active CLIA laboratory certificates, maintains a secondary practice location in Ormond Beach, and lists Cory Domayer, Vp, as its authorized official.

NPPES Registry Identity

NPI1275640997
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameMEMORIAL HEALTH SYSTEMS INC
Location Address61 MEMORIAL MEDICAL PKWY STE 2811Palm Coast, FL 32164-5999
Mailing AddressPo Box 730729Ormond Beach, FL 32173-0729 · (386) 671-4500 · Fax (386) 672-9904
Phone(386) 671-4519
Organization SubpartNo
Authorized OfficialCory DomayerVp · (383) 231-3906
Enumeration DateAugust 25, 2006
Last NPPES UpdateFebruary 26, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 26, 2021
✔ NPI 1275640997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
61 MEMORIAL MEDICAL PKWY STE 2811, Palm Coast, FL 32164
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Other Names 1

Doing Business AsAdventhealth Medical Group

Secondary Practice Location 1

Location 1875 Sterthaus AveOrmond Beach, FL 32174-5131 · Phone (386) 671-4500 · Fax (386) 672-9904

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 17

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 10D2300473

Adventhealth Medical Group Urology At Palm Coast · Palm Coast, FL
Active · expires Mar 11, 2028
CLIA Number10D2300473
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorEarle Pescatore
Laboratory Phone(386) 231-5386
Laboratory LocationAdventhealth Medical Group Urology At Palm Coast61 Memorial Medical Parkway, Suite 3807, Palm Coast, FL 32164
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2004597

Adventhealth Medical Group Family Medicine At Palm Coast -Ste 2806 · Palm Coast, FL
Active · expires Mar 8, 2028
CLIA Number10D2004597
Laboratory TypePhysician Office
Certificate Effective DateMarch 9, 2026
Certificate Expiration DateMarch 8, 2028
Laboratory DirectorMatthew Zoght
Laboratory Phone(386) 586-1920
Laboratory LocationAdventhealth Medical Group Family Medicine At Palm Coast -Ste 280661 Memorial Medical Pkwy Ste 2806, Palm Coast, FL 32164
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D1080939

Adventhealth Medical Group Internal Medicine At Palm Copast · Palm Coast, FL
Active · expires Mar 5, 2028
CLIA Number10D1080939
Laboratory TypePhysician Office
Certificate Effective DateMarch 6, 2026
Certificate Expiration DateMarch 5, 2028
Laboratory DirectorMini Paul
Laboratory Phone(386) 586-3466
Laboratory LocationAdventhealth Medical Group Internal Medicine At Palm Copast21 Hospital Dr - Ste 230, Palm Coast, FL 32164
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2334132

Adventhealth Medical Group Urology At Town Center · Palm Coast, FL
Active · expires Nov 16, 2027
CLIA Number10D2334132
Laboratory TypePhysician Office
Certificate Effective DateNovember 17, 2025
Certificate Expiration DateNovember 16, 2027
Laboratory DirectorRalph Highshaw
Laboratory Phone(386) 586-1705
Laboratory LocationAdventhealth Medical Group Urology At Town Center21 Hospital Dr Suite #125, Palm Coast, FL 32164
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D1074671

Adventhealth Medical Group Pediatrics At Palm Coast · Palm Coast, FL
Active · expires Nov 1, 2027
CLIA Number10D1074671
Laboratory TypePhysician Office
Certificate Effective DateNovember 2, 2025
Certificate Expiration DateNovember 1, 2027
Laboratory DirectorMichael F. Davis
Laboratory Phone(386) 986-4919
Laboratory LocationAdventhealth Medical Group Pediatrics At Palm Coast61 Memorial Medical Pkwy, Ste 3811, Palm Coast, FL 32164
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D1046166

Adventhealth Medical Group Family Medicine At Ormond Beach Granada · Ormond Beach, FL
Active · expires Oct 2, 2027
CLIA Number10D1046166
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2025
Certificate Expiration DateOctober 2, 2027
Laboratory DirectorMaleeha Ahmad
Laboratory Phone(386) 804-7143
Laboratory LocationAdventhealth Medical Group Family Medicine At Ormond Beach Granada1050 W Granada Blvd Ste 2A, Ormond Beach, FL 32174
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

JENISSA DENEE LEITE DA SILVA PA-C
Physician Assistant
61 MEMORIAL MEDICAL PKWY STE 2811
PALM COAST, FL 32164
Flagler County (386) 586-1955
DR. BRETT MATTHEW SASSEEN MD
Internal Medicine (Interventional Cardiology)
61 MEMORIAL MEDICAL PKWY STE 2811
PALM COAST, FL 32164
Flagler County (386) 586-1955
ASHLEY GILMORE FNP-C
Nurse Practitioner (Family)
61 MEMORIAL MEDICAL PKWY STE 2811
PALM COAST, FL 32164
Flagler County (386) 586-1955
ALLISON KAROL SEVERINO APRN
Nurse Practitioner
61 MEMORIAL MEDICAL PKWY STE 2811
PALM COAST, FL 32164
Flagler County (386) 586-1870
DR. DEAN MEHDI ABTAHI M.D.
Internal Medicine (Cardiovascular Disease)
61 MEMORIAL MEDICAL PKWY STE 2811
PALM COAST, FL 32164
Flagler County (386) 586-1955
BREANNA BLACKLEDGE
Nurse Practitioner
61 MEMORIAL MEDICAL PKWY STE 2811
PALM COAST, FL 32164
Flagler County (386) 586-1955

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 Health Systems Inc's NPI number?

The NPI number for Memorial Health Systems Inc is 1275640997. It was assigned to this organization in the NPPES registry on August 25, 2006. The provider is doing business as Adventhealth Medical Group.

Where is Memorial Health Systems Inc located?

Memorial Health Systems Inc is located at 61 Memorial Medical Pkwy Ste 2811, Palm Coast, FL 32164. The listed phone number is (386) 671-4519.

What is Memorial Health Systems Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Memorial Health Systems Inc hold CLIA laboratory certificates?

Yes. 16 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Memorial Health Systems Inc accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Memorial Health Systems Inc 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 Memorial Health Systems Inc was last updated on February 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.