Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 010001 SOUTHEAST ALABAMA MEDICAL CENTER 1108 ROSS CLARK CIRCLE DOTHAN AL 36301 HOUSTON 3347938701 010005 MARSHALL MEDICAL CENTER SOUTH 2505 U S HIGHWAY 431 NORTH BOAZ AL 35957 MARSHALL 2565938310 010006 ELIZA COFFEE MEMORIAL HOSPITAL 205 MARENGO STREET FLORENCE AL 35631 LAUDERDALE 2567688400 010007 MIZELL MEMORIAL HOSPITAL 702 N MAIN ST OPP AL 36467 COVINGTON 3344933541 010008 CRENSHAW COMMUNITY HOSPITAL 101 HOSPITAL CIRCLE LUVERNE AL 36049 CRENSHAW 3343353374 010011 ST VINCENT'S EAST 50 MEDICAL PARK EAST DRIVE BIRMINGHAM AL 35235 JEFFERSON 2058383122 010012 DEKALB REGIONAL MEDICAL CENTER 200 MED CENTER DRIVE FORT PAYNE AL 35968 DEKALB 2568453150 010016 SHELBY BAPTIST MEDICAL CENTER 1000 FIRST STREET NORTH ALABASTER AL 35007 SHELBY 2056208100 010018 CALLAHAN EYE HOSPITAL 1720 UNIVERSITY BLVD BIRMINGHAM AL 35233 JEFFERSON 2053258100 010019 HELEN KELLER MEMORIAL HOSPITAL 1300 SOUTH MONTGOMERY AVENUE SHEFFIELD AL 35660 COLBERT 2563864556 010021 DALE MEDICAL CENTER 126 HOSPITAL AVE OZARK AL 36360 DALE 3347742601 010022 CHEROKEE MEDICAL CENTER 400 NORTHWOOD DR CENTRE AL 35960 CHEROKEE 2569275531 010023 BAPTIST MEDICAL CENTER SOUTH 2105 EAST SOUTH BOULEVARD MONTGOMERY AL 36116 MONTGOMERY 3342882100 010024 JACKSON HOSPITAL & CLINIC INC 1725 PINE STREET MONTGOMERY AL 36106 MONTGOMERY 3342938000 010029 EAST ALABAMA MEDICAL CENTER 2000 PEPPERELL PARKWAY OPELIKA AL 36801 LEE 3347493411 010032 WEDOWEE HOSPITAL 209 NORTH MAIN STREET WEDOWEE AL 36278 RANDOLPH 2563572111 010033 UNIVERSITY OF ALABAMA HOSPITAL 619 SOUTH 19TH STREET BIRMINGHAM AL 35233 JEFFERSON 2059344011 010034 COMMUNITY HOSPITAL INC 805 FRIENDSHIP ROAD TALLASSEE AL 36078 ELMORE 3342836541 010035 CULLMAN REGIONAL MEDICAL CENTER 1912 ALABAMA HIGHWAY 157 CULLMAN AL 35058 CULLMAN 2567372000 010036 ANDALUSIA REGIONAL HOSPITAL 849 SOUTH THREE NOTCH STREET ANDALUSIA AL 36420 COVINGTON 3342228466 010038 STRINGFELLOW MEMORIAL HOSPITAL 301 EAST 18TH ST ANNISTON AL 36201 CALHOUN 2562358900 010039 HUNTSVILLE HOSPITAL 101 SIVLEY RD HUNTSVILLE AL 35801 MADISON 2562651000 010040 GADSDEN REGIONAL MEDICAL CENTER 1007 GOODYEAR AVENUE GADSDEN AL 35903 ETOWAH 2564944000 010044 MARION REGIONAL MEDICAL CENTER 1256 MILITARY STREET SOUTH HAMILTON AL 35570 MARION 2059216200 010045 FAYETTE MEDICAL CENTER 1653 TEMPLE AVENUE NORTH FAYETTE AL 35555 FAYETTE 2059325966 010046 RIVERVIEW REGIONAL MEDICAL CENTER 600 SOUTH THIRD STREET GADSDEN AL 35901 ETOWAH 2565435200 010047 GEORGIANA MEDICAL CENTER 515 N MIRANDA AVENUE GEORGIANA AL 36033 BUTLER 3343762205 010049 MEDICAL CENTER ENTERPRISE 400 N EDWARDS STREET ENTERPRISE AL 36330 COFFEE 3343470584 010051 GREENE COUNTY HOSPITAL 509 WILSON AVENUE EUTAW AL 35462 GREENE 2053723388 010052 LAKE MARTIN COMMUNITY HOSPITAL 201 MARIARDEN ROAD DADEVILLE AL 36853 TALLAPOOSA 2568257821
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 1 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 010055 FLOWERS HOSPITAL 4370 WEST MAIN STREET DOTHAN AL 36305 HOUSTON 3347935000 010056 ST VINCENT'S BIRMINGHAM 810 ST VINCENT'S DRIVE BIRMINGHAM AL 35205 JEFFERSON 2059397000 010058 BIBB MEDICAL CENTER 208 PIERSON AVE CENTREVILLE AL 35042 BIBB 2059264881 010059 LAWRENCE MEDICAL CENTER 202 HOSPITAL STREET MOULTON AL 35650 LAWRENCE 2569742200 010061 HIGHLANDS MEDICAL CENTER 380 WOODS COVE ROAD SCOTTSBORO AL 35768 JACKSON 2562594444 010062 WIREGRASS MEDICAL CENTER 1200 W MAPLE AVENUE GENEVA AL 36340 GENEVA 3346843655 010065 RUSSELL HOSPITAL 3316 HIGHWAY 280 ALEXANDER CITY AL 35010 TALLAPOOSA 2563297100 010069 MEDICAL CENTER BARBOUR 820 W WASHINGTON ST EUFAULA AL 36027 BARBOUR 3346887271 010073 CLAY COUNTY HOSPITAL 83825 HIGHWAY 9 P O BOX 1270 ASHLAND AL 36251 CLAY 2563542131 010078 NORTHEAST ALABAMA REGIONAL MEDICAL CENTER 400 EAST 10TH STREET ANNISTON AL 36207 CALHOUN 2562355121 010079 ATHENS LIMESTONE HOSPITAL 700 WEST MARKET STREET ATHENS AL 35611 LIMESTONE 2562339292 010083 SOUTH BALDWIN REGIONAL MEDICAL CENTER 1613 NORTH MCKENZIE STREET FOLEY AL 36535 BALDWIN 2519493400 010085 DECATUR MORGAN HOSPITAL‐DECATUR CAMPUS 1201 7TH STREET SE DECATUR AL 35601 MORGAN 2563412000 010086 NORTHWEST MEDICAL CENTER 1530 U S HIGHWAY 43 WINFIELD AL 35594 MARION 2054877736 010087 UNIVERSITY OF SOUTH ALABAMA MEDICAL CENTER 2451 FILLINGIM STREET MOBILE AL 36617 MOBILE 2514717110 010089 WALKER BAPTIST MEDICAL CENTER 3400 HIGHWAY 78 EAST JASPER AL 35502 WALKER 2053874000 010090 PROVIDENCE HOSPITAL 6801 AIRPORT BOULEVARD MOBILE AL 36608 MOBILE 2516331000 010091 GROVE HILL MEMORIAL HOSPITAL 295 JACKSON HWY SGROVE HILL AL 36451 CLARKE 2512753191 010092 D C H REGIONAL MEDICAL CENTER 809 UNIVERSITY BOULEVARD EAST TUSCALOOSA AL 35401 TUSCALOOSA 2057597111 010095 HALE COUNTY HOSPITAL 508 GREEN STREET GREENSBORO AL 36744 HALE 3346243024 010097 ELMORE COMMUNITY HOSPITAL 500 HOSPITAL DRIVE WETUMPKA AL 36092 ELMORE 3345674311 010099 D W MCMILLAN MEMORIAL HOSPITAL 1301 BELLEVILLE AVENUE BREWTON AL 36426 ESCAMBIA 2518678061 010100 THOMAS HOSPITAL 750 MORPHY AVENUE FAIRHOPE AL 36532 BALDWIN 2519282375 010101 CITIZENS BAPTIST MEDICAL CENTER 604 STONE AVENUE TALLADEGA AL 35161 TALLADEGA 2567614542 010102 J PAUL JONES HOSPITAL 317 MCWILLIAMS AVENUE CAMDEN AL 36726 WILCOX 3346824131 010103 BAPTIST MEDICAL CENTER‐PRINCETON 701 PRINCETON AVENUE SOUTHWEST BIRMINGHAM AL 35211 JEFFERSON 2057833800 010104 GRANDVIEW MEDICAL CENTER 3690 GRANDVIEW PARKWAY BIRMINGHAM AL 35243 JEFFERSON 2055921000 010108 PRATTVILLE BAPTIST HOSPITAL 124 S MEMORIAL DR PRATTVILLE AL 36067 AUTAUGA 3343614267 010109 PICKENS COUNTY MEDICAL CENTER 241 ROBERT K WILSON DRIVE CARROLLTON AL 35447 PICKENS 2053678111 010110 BULLOCK COUNTY HOSPITAL 102 WEST CONECUH AVENUE UNION SPRINGS AL 36089 BULLOCK 3347382140
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 2 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 010112 BRYAN W. WHITFIELD MEMORIAL HOSPITAL 105 HIGHWAY 80 EAST DEMOPOLIS AL 36732 MARENGO 3342894000 010113 MOBILE INFIRMARY MEDICAL CENTER 5 MOBILE INFIRMARY CIRCLE MOBILE AL 36652 MOBILE 2514354700 010114 MEDICAL WEST, AN AFFILIATE OF UAB HEALTH SYSTEM 995 9TH AVENUE SOUTHWEST BESSEMER AL 35021 JEFFERSON 2054817000
010118 VAUGHAN REGIONAL MEDICAL CENTER PARKWAY CAMPUS 1015 MEDICAL CENTER PARKWAY SELMA AL 36701 DALLAS 3344184100
010120 MONROE COUNTY HOSPITAL 2016 SOUTH ALABAMA AVENUE, BOX 886 MONROEVILLE AL 36460 MONROE 2515753111 010125 LAKELAND COMMUNITY HOSPITAL 42024 HIGHWAY 195 E HALEYVILLE AL 35565 WINSTON 2054857117 010126 TROY REGIONAL MEDICAL CENTER 1330 HIGHWAY 231 SOUTH TROY AL 36081 PIKE 3346705000 010128 JACKSON MEDICAL CENTER 220 HOSPITAL DRIVE JACKSON AL 36545 CLARKE 2512469021 010129 NORTH BALDWIN INFIRMARY 1815 HAND AVENUE BAY MINETTE AL 36507 BALDWIN 2519375521 010130 ST VINCENT'S ST CLAIR 7063 VETERANS PARKWAY PELL CITY AL 35125 ST. CLAIR 2053383301 010131 CRESTWOOD MEDICAL CENTER ONE HOSPITAL DR SE HUNTSVILLE AL 35801 MADISON 2568823100 010138 HILL HOSPITAL OF SUMTER COUNTY 751 DERBY DRIVE YORK AL 36925 SUMTER 2053925263 010139 BROOKWOOD MEDICAL CENTER 2010 BROOKWOOD MEDICAL CENTER DRIVE BIRMINGHAM AL 35209 JEFFERSON 2058771000 010144 SPRINGHILL MEMORIAL HOSPITAL 3719 DAUPHIN STREET MOBILE AL 36608 MOBILE 2513449630 010146 RMC JACKSONVILLE 1701 SOUTH PELHAM ROAD JACKSONVILLE AL 36265 CALHOUN 2567824538 010148 EVERGREEN MEDICAL CENTER 101 CRESTVIEW AVENUE EVERGREEN AL 36401 CONECUH 2515782480 010149 BAPTIST MEDICAL CENTER EAST 400 TAYLOR ROAD MONTGOMERY AL 36117 MONTGOMERY 3342448330 01014F BIRMINGHAM VA MEDICAL CENTER 700 S 19TH ST BIRMINGHAM AL 35233 JEFFERSON 2059338101 010150 L V STABLER MEMORIAL HOSPITAL 29 L V STABLER DRIVE GREENVILLE AL 36037 BUTLER 3343822200 010157 SHOALS HOSPITAL 201 WEST AVALON AVENUE MUSCLE SHOALS AL 35661 COLBERT 2563861601 010158 RUSSELLVILLE HOSPITAL 15155 HIGHWAY 43 RUSSELLVILLE AL 35653 FRANKLIN 2563321611 010164 COOSA VALLEY MEDICAL CENTER 315 W HICKORY ST SYLACAUGA AL 35150 TALLADEGA 2562495000 010167 UAB HIGHLANDS 1201 11TH AVENUE SOUTH BIRMINGHAM AL 35205 JEFFERSON 2059307000 010168 JACK HUGHSTON MEMORIAL HOSPITAL 4401 RIVER CHASE DRIVE PHENIX CITY AL 36867 RUSSELL 3347323000 010169 ATMORE COMMUNITY HOSPITAL 401 MEDICAL PARK DRIVE ATMORE AL 36502 ESCAMBIA 2513682500 01019F CENTRAL AL VETERANS HLTH CARE SYSTEM WEST CAMPUS 215 PERRY HILL RD MONTGOMERY AL 36109 MONTGOMERY 3342724670
01021F TUSCALOOSA VA MEDICAL CENTER 3701 LOOP ROAD EAST TUSCALOOSA AL 35404 TUSCALOOSA 2055542000 01022F CENTRAL AL VETERANS HLTH CARE SYSTEM EAST CAMPUS 2400 HOSPITAL RD TUSKEGEE AL 36083 MACON 3347270550
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 3 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 011300 WASHINGTON COUNTY HOSPITAL 14600 ST. STEPHENS AVENUE CHATOM AL 36518 WASHINGTON 2518472223 011302 RED BAY HOSPITAL 211 HOSPITAL ROAD RED BAY AL 35582 FRANKLIN 2563569532 011304 CHOCTAW GENERAL HOSPITAL 401 VANITY FAIR LANE, PO BOX 618 BUTLER AL 36904 CHOCTAW 2054599100 011305 ST VINCENTS BLOUNT 150 GILBREATH DRIVE ONEONTA AL 35121 BLOUNT 2052743000 012006 INFIRMARY LTAC HOSPITAL 5 MOBILE INFIRMARY CIRCLE MOBILE AL 36607 MOBILE 2516605611 012007 NOLAND HOSPITAL MONTGOMERY II, LLC 1725 PINE STREET 5TH FLOOR NORTH WING MONTGOMERY AL 36106 MONTGOMERY 3342400532 012008 SELECT SPECIALTY HOSPITAL ‐ BIRMINGHAM 2010 BROOKWOOD MEDICAL CENTER DRIVE, 3RD FLOOR BIRMINGHAM AL 35209 JEFFERSON 2055994595
012009 NOLAND HOSPITAL BIRMINGHAM II, LLC 50 MEDICAL PARK EAST DRIVE 8TH FLOOR BIRMINGHAM AL 35235 JEFFERSON 2058385100 012010 NOLAND HOSPITAL DOTHAN II, LLC 1108 ROSS CLARK CIRCLE, 4TH FLOOR DOTHAN AL 36302 HOUSTON 3346994300 012011 NOLAND HOSPITAL ANNISTON II, LLC 400 EAST 10TH STREET, 4TH FLOOR ANNISTON AL 36202 CALHOUN 2567416141 012012 NOLAND HOSPITAL TUSCALOOSA II, LLC 809 UNIVERSITY BOULEVARD EAST, 4TH FLOOR TUSCALOOSA AL 35401 TUSCALOOSA 2057597241 012013 NOLAND HOSPITAL SHELBY II, LLC 1000 FIRST STREET, 3RD FLOOR ALABASTER AL 35007 SHELBY 2056208641 013025 HEALTHSOUTH LAKESHORE REHABILITATION HOSPITAL 3800 RIDGEWAY DRIVE BIRMINGHAM AL 35209 JEFFERSON 2058682000
013028 HEALTHSOUTH REHABILITATION HOSPITAL OF 4465 NARROW LANE RD MONTGOMERY AL 36116 MONTGOMERY 3342847821 MONTGOMERY 013029 HEALTHSOUTH REHABILITATION HOSPITAL OF NORTH AL 107 GOVERNORS DRIVE HUNTSVILLE AL 35801 MADISON 2055352300
013030 HEALTHSOUTH REHABILITATION HOSPITAL 1736 EAST MAIN STREET DOTHAN AL 36301 HOUSTON 3347126333 013032 HEALTHSOUTH REHABILITATION HOSPITAL OF GADSDEN 801 GOODYEAR AVE GADSDEN AL 35903 ETOWAH 2564395000
013033 REGIONAL REHABILITATION HOSPITAL 3715 HIGHWAY 280 PHENIX CITY AL 36869 RUSSELL 3347322200 013300 CHILDREN'S HOSPITAL OF ALABAMA 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 JEFFERSON 2059399100 013301 UNIVERSITY OF S A CHILDREN'S AND WOMEN'S HOS 1700 CENTER STREET MOBILE AL 36604 MOBILE 2514151000 014000 HILL CREST BEHAVIORAL HEALTH SERVICES 6869 FIFTH AVENUE SOUTH BIRMINGHAM AL 35212 JEFFERSON 2058339000 014006 MOUNTAIN VIEW HOSPITAL 3201 SCENIC HIGHWAY GADSDEN AL 35902 ETOWAH 2565469265 014007 BRYCE HOSPITAL 200 UNIVERSITY BLVD TUSCALOOSA AL 35401 TUSCALOOSA 2057590750 014012 MARY S HARPER GERIATRIC PSYCHIATRY CENTER 201 UNIVERSITY BLVD TUSCALOOSA AL 35401 TUSCALOOSA 2057590900 014013 LAUREL OAKS BEHAVIORAL HEALTH CENTER 700 EAST COTTONWOOD RD DOTHAN AL 36301 HOUSTON 3347947393 014014 BAYPOINTE BEHAVIORAL HEALTH 5800 SOUTHLAND DRIVE MOBILE AL 36693 MOBILE 2516627998 014015 BEACON CHILDREN'S HOSPITAL 150 HOSPITAL DRIVE LUVERNE AL 36049 CRENSHAW 3343355040
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 4 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 014016 SANCTUARY AT THE WOODLANDS, THE 1910 CHEROKEE AVENUE, SW CULLMAN AL 35055 CULLMAN 2567391239 014017 EASTPOINTE HOSPITAL 7400 ROPER LANE DAPHNE AL 36526 BALDWIN 2513786500 014018 BEHAVIORAL HEALTHCARE CENTER AT HUNTSVILLE, INC 5315 MILLENIUM DRIVE, NW HUNTSVILLE AL 35806 MADISON 2569646700
019800 UNIVERSITY OF ALABAMA HOSPITAL 619 SOUTH 19TH STREET BIRMINGHAM AL 35233 JEFFERSON 2059344011 019801 CHILDREN'S HOSPITAL OF ALABAMA 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 JEFFERSON 2056389828 020001 PROVIDENCE ALASKA MEDICAL CENTER 3200 PROVIDENCE DRIVE ANCHORAGE AK 99508 9075622211 020006 MAT‐SU REGIONAL MEDICAL CENTER 2500 SOUTH WOODWORTH LOOP PALMER AK 99645 MATANUSKA‐SUSITNA 9078616000 020008 BARTLETT REGIONAL HOSPITAL 3260 HOSPITAL DR JUNEAU AK 99801 9077968900 020012 FAIRBANKS MEMORIAL HOSPITAL 1650 COWLES STREET FAIRBANKS AK 99701 FAIRBANKS NORTH STAR 9074528181 020017 ALASKA REGIONAL HOSPITAL 2801 DEBARR ROAD ANCHORAGE AK 99508 9072761131 020018 YUKON KUSKOKWIM DELTA REG HOSPITAL PO BOX 287 BETHEL AK 99559 9075436300 020024 CENTRAL PENINSULA GENERAL HOSPITAL 250 HOSPITAL PLACE SOLDOTNA AK 99669 9072624404 020026 ALASKA NATIVE MEDICAL CENTER 4315 DIPLOMACY DR ANCHORAGE AK 99508 9075632662 02003F US PUBLIC HEALTH SERVICE HOSP 3RD + GAMBLE STS ANCHORAGE AK 99501 02009F US NAVAL HOSP P O BOX 11 NAVY 320 SEATTLE WASH ANCHORAGE AK 99504 02010F US NAVY STATION HOSP KODIAK AK 99615 KODIAK ISLAND 02011F US AIR FORCE DISPENSARY APO SEATTLE WASHINGTON KENAI AK 99611 02012F US AIR FORCE HOSP ELLISTON AFB APO 937 SEATTLE WASH FAIRBANKS AK 99702 FAIRBANKS NORTH STAR 02015E HARBORVIEW MEM HOSP P O BOX 548 VALDEZ AK 99686 021301 PROVIDENCE VALDEZ MEDICAL CENTER PO BOX 550 VALDEZ AK 99686 9078352249 021302 PROVIDENCE SEWARD HOSPITAL 417 FIRST AVENUE, PO BOX 365 SEWARD AK 99664 9072245205 021303 SITKA COMMUNITY HOSPITAL 209 MOLLER DRIVE SITKA AK 99835 9077473241 021304 PETERSBURG MEDICAL CENTER PO BOX 589 PETERSBURG AK 99833 9077724291 021305 WRANGELL MEDICAL CENTER 310 BENNETT STREET PO BOX 1081 WRANGELL AK 99929 9078747000 021306 PROVIDENCE KODIAK ISLAND MEDICAL CTR 1915 EAST REZANOF DRIVE KODIAK AK 99615 KODIAK ISLAND 9074869592 021307 CORDOVA COMMUNITY MEDICAL CENTER PO BOX 160 ‐ 602 CHASE AVENUE CORDOVA AK 99574 9074248000 021308 NORTON SOUND REGIONAL HOSPITAL 1000 GREG KRUSCHEK AVENUE (P O BOX 966) NOME AK 99762 9074433311 021309 KANAKANAK HOSPITAL P O BOX 130 DILLINGHAM AK 99576 9078425201 021310 MANIILAQ HEALTH CENTER PO BOX 43 KOTZEBUE AK 99752 NORTHWEST ARCTIC 9074423321
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 5 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 021311 KETCHIKAN MEDICAL CENTER 3100 TONGASS AVENUE KETCHIKAN AK 99901 KETCHIKAN GATEWAY 9072255171 021312 SAMUEL SIMMONDS MEMORIAL HOSPITAL 7000 UULA ST BARROW AK 99723 9078524611 021313 SOUTH PENINSULA HOSPITAL 4300 BARTLETT ST HOMER AK 99603 9072358101 021314 MT EDGECUMBE HOSPITAL 222 TONGASS DR SITKA AK 99835 9079662411 022001 ST ELIAS SPECIALTY HOSPITAL 4800 CORDOVA STREET ANCHORAGE AK 99503 9075613333 024001 NORTH STAR HOSPITAL 2530 DEBARR RD ANCHORAGE AK 99508 9072643526 024002 ALASKA PSYCHIATRIC INSTITUTE 3700 PIPER STREET ANCHORAGE AK 99508 9072697100 030001 ABRAZO MARYVALE CAMPUS 5102 WEST CAMPBELL AVENUE PHOENIX AZ 85031 MARICOPA 6238485000 030002 BANNER ‐ UNIVERSITY MEDICAL CENTER PHOENIX 1111 EAST MCDOWELL ROAD PHOENIX AZ 85006 MARICOPA 6022392000 030006 TUCSON MEDICAL CENTER 5301 EAST GRANT ROAD TUCSON AZ 85712 PIMA 5203275461 030007 VERDE VALLEY MEDICAL CENTER 269 SOUTH CANDY LANE COTTONWOOD AZ 86326 YAVAPAI 9286396058 030010 ST. MARY'S HOSPITAL 1601 WEST ST MARY'S ROAD TUCSON AZ 85745 PIMA 5208723000 030011 ST JOSEPH'S HOSPITAL 350 NORTH WILMOT ROAD TUCSON AZ 85711 PIMA 5208733000 030012 YAVAPAI REGIONAL MEDICAL CENTER 1003 WILLOW CREEK ROAD PRESCOTT AZ 86301 YAVAPAI 9284452700 030013 YUMA REGIONAL MEDICAL CENTER 2400 SOUTH AVENUE A YUMA AZ 85364 YUMA 9283367600 030014 JOHN C. LINCOLN MEDICAL CENTER 250 EAST DUNLAP AVENUE PHOENIX AZ 85020 MARICOPA 6028706060 030016 BANNER CASA GRANDE MEDICAL CENTER 1800 EAST FLORENCE BOULEVARD CASA GRANDE AZ 85222 PINAL 5203816300 03001E CRIPPLED CHILDRENS HOSP 1825 E GARFIELD ST PHOENIX AZ 85006 MARICOPA 030022 MARICOPA MEDICAL CENTER 2601 EAST ROOSEVELT STREET PHOENIX AZ 85008 MARICOPA 6023445011 030023 FLAGSTAFF MEDICAL CENTER 1200 NORTH BEAVER STREET FLAGSTAFF AZ 86001 COCONINO 9287732378 030024 ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER 350 WEST THOMAS ROAD PHOENIX AZ 85013 MARICOPA 6024065001 03002E UNIVERSITY PHYSICIANS HOSPITAL AT KINO, THE 2800 EAST AJO WAY TUCSON AZ 85713 PIMA 5202944471 030030 ABRAZO CENTRAL CAMPUS 2000 WEST BETHANY HOME ROAD PHOENIX AZ 85015 MARICOPA 6022490212 030033 BANNER PAYSON MEDICAL CENTER 807 SOUTH PONDEROSA DRIVE PAYSON AZ 85541 GILA 9284743222 030036 CHANDLER REGIONAL MEDICAL CENTER 1955 WEST FRYE ROAD CHANDLER AZ 85224 MARICOPA 4807283000 030037 ST LUKE'S MEDICAL CENTER 1800 EAST VAN BUREN STREET PHOENIX AZ 85006 MARICOPA 6022518156 030038 SCOTTSDALE OSBORN MEDICAL CENTER 7400 EAST OSBORN ROAD SCOTTSDALE AZ 85251 MARICOPA 4808824000 030043 CANYON VISTA MEDICAL CENTER 5700 EAST HIGHWAY 90 SIERRA VISTA AZ 85635 COCHISE 5204173001 03004F US AIR FORCE HOSP DAVIS‐MONTHAN AFB TUCSON AZ 85707 PIMA 5201111111 030055 KINGMAN REGIONAL MEDICAL CENTER 3269 STOCKTON HILL ROAD KINGMAN AZ 86409 MOHAVE 9287572101
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 6 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 03005F US AIR FORCE HOSP ‐ CLOSED LUKE AFB GLENDALE AZ 85301 MARICOPA 6021111111 030061 BANNER BOSWELL MEDICAL CENTER 10401 WEST THUNDERBIRD BOULEVARD SUN CITY AZ 85351 MARICOPA 6238324000 030062 SUMMIT HEALTHCARE REGIONAL MEDICAL CENTER 2200 EAST SHOW LOW LAKE ROAD SHOW LOW AZ 85901 NAVAJO 9285376399 030064 BANNER‐UNIVERSITY MEDICAL CENTER TUCSON CAMPUS 1501 NORTH CAMPBELL AVENUE TUCSON AZ 85724 PIMA 5208744189
030065 BANNER DESERT MEDICAL CENTER 1400 SOUTH DOBSON ROAD MESA AZ 85202 MARICOPA 4804123000 030068 MT. GRAHAM REGIONAL MEDICAL CENTER 1600 SOUTH 20TH AVENUE SAFFORD AZ 85546 GRAHAM 9283484000 030069 HAVASU REGIONAL MEDICAL CENTER 101 CIVIC CENTER LANE LAKE HAVASU CITY AZ 86403 MOHAVE 9288558185 03006F US AIR FORCE HOSP WILLIAMS AFB CHANDLER AZ 85224 MARICOPA 0001112222 030071 FORT DEFIANCE INDIAN HOSPITAL PO BOX 649 FORT DEFIANCE AZ 86504 APACHE 9287298000 030073 TUBA CITY REGIONAL HEALTH CARE CORPORATION PO BOX 600 TUBA CITY AZ 86045 COCONINO 9282832501 030074 SELLS INDIAN HEALTH SERVICE HOSPITAL PO BOX 548 SELLS AZ 85634 PIMA 5203837200 030077 SAN CARLOS APACHE HEALTHCARE 103 MEDICINE WAY ROAD PERIDOT AZ 85542 GILA 9284751200 030078 PHOENIX INDIAN MEDICAL CENTER 4212 NORTH 16TH STREET PHOENIX AZ 85016 MARICOPA 6022631200 03007F US ARMY HOSP 45001 WINROW SREET FORT HUACHUCA AZ 85613 COCHISE 5204444444 030083 ABRAZO SCOTTSDALE CAMPUS 3929 EAST BELL ROAD PHOENIX AZ 85032 MARICOPA 6029235000 030084 CHINLE COMPREHENSIVE HEALTH CARE FACILITY US HWY 191, HOSPITAL ROAD CHINLE AZ 86503 APACHE 9286747001 030085 NORTHWEST MEDICAL CENTER 6200 NORTH LA CHOLLA BOULEVARD TUCSON AZ 85741 PIMA 5204698100 030087 SCOTTSDALE SHEA MEDICAL CENTER 9003 EAST SHEA BOULEVARD SCOTTSDALE AZ 85260 MARICOPA 4803233009 030088 BANNER BAYWOOD MEDICAL CENTER 6644 EAST BAYWOOD AVENUE MESA AZ 85206 MARICOPA 4806845898 030089 BANNER THUNDERBIRD MEDICAL CENTER 5555 WEST THUNDERBIRD ROAD GLENDALE AZ 85306 MARICOPA 4806845898 030092 HONORHEALTH DEER VALLEY MEDICAL CENTER 19829 NORTH 27TH AVENUE PHOENIX AZ 85027 MARICOPA 6238796100 030093 BANNER DEL E. WEBB MEDICAL CENTER 14502 WEST MEEKER BOULEVARD SUN CITY WEST AZ 85375 MARICOPA 6235244000 030094 ABRAZO ARROWHEAD CAMPUS 18701 NORTH 67TH AVENUE GLENDALE AZ 85308 MARICOPA 6235611000 030101 WESTERN ARIZONA REGIONAL MEDICAL CENTER 2735 SILVER CREEK ROAD BULLHEAD CITY AZ 86442 MOHAVE 9287632273 030103 MAYO CLINIC HOSPITAL 5777 EAST MAYO BOULEVARD PHOENIX AZ 85054 MARICOPA 4803422000 030105 BANNER HEART HOSPITAL 6750 EAST BAYWOOD AVENUE MESA AZ 85206 MARICOPA 4808545050 030107 ARIZONA SPINE AND JOINT HOSPITAL 4620 EAST BASELINE ROAD MESA AZ 85206 MARICOPA 4808324770 030108 CORE INSTITUTE SPECIALTY HOSPITAL, THE 6501 NORTH 19TH AVENUE PHOENIX AZ 85015 MARICOPA 6027956020 030110 ABRAZO WEST CAMPUS 13677 WEST MCDOWELL ROAD GOODYEAR AZ 85395 MARICOPA 6238821515
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 7 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 030111 BANNER‐UNIVERSITY MEDICAL CENTER SOUTH CAMPUS 2800 EAST AJO WAY TUCSON AZ 85713 PIMA 5202944471
030112 ARIZONA ORTHOPEDIC AND SURGICAL SPECIALITY HOSP 2905 WEST WARNER ROAD CHANDLER AZ 85224 MARICOPA 4806039000
030113 WHITERIVER PHS INDIAN HOSPITAL 200 WEST HOSPITAL DRIVE (PO BOX 860) WHITERIVER AZ 85941 NAVAJO 9283384911 030114 ORO VALLEY HOSPITAL 1551 EAST TANGERINE ROAD ORO VALLEY AZ 85755 PIMA 5209013549 030115 BANNER ESTRELLA MEDICAL CENTER 9201 WEST THOMAS ROAD PHOENIX AZ 85037 MARICOPA 6233274000 030117 VALLEY VIEW MEDICAL CENTER 5330 SOUTH HIGHWAY 95 FORT MOHAVE AZ 86426 MOHAVE 9287887252 030118 YAVAPAI REGIONAL MEDICAL CENTER‐EAST CAMPUS 7700 EAST FLORENTINE ROAD PRESCOTT VALLEY AZ 86314 YAVAPAI 9287715676 030119 MERCY GILBERT MEDICAL CENTER 3555 SOUTH VAL VISTA DRIVE GILBERT AZ 85296 MARICOPA 4807288000 03011F FT APACHE P H S INDIAN HOSP UNKNOWN ADDRESS WHITERIVER AZ 85941 NAVAJO 6024444444 030120 GILBERT HOSPITAL 5656 SOUTH POWER ROAD GILBERT AZ 85295 MARICOPA 4808403715 030121 MOUNTAIN VISTA MEDICAL CENTER, LP 1301 SOUTH CRISMON ROAD MESA AZ 85209 MARICOPA 4803586100 030122 BANNER GATEWAY MEDICAL CENTER 1900 NORTH HIGLEY ROAD GILBERT AZ 85234 MARICOPA 4805432000 030123 SCOTTSDALE THOMPSON PEAK MEDICAL CENTER 7400 EAST THOMPSON PEAK PARKWAY SCOTTSDALE AZ 85255 MARICOPA 4803247004 03012F VA HOSP CARL T HAYDEN VA MEDICAL CENTER 650 EAST INDIAN SCHOOL RD PHOENIX AZ 85012 MARICOPA 6022775551 030130 BANNER IRONWOOD MEDICAL CENTER 37000 NORTH GANTZEL ROAD SAN TAN VALLEY AZ 85140 PINAL 4803944030 030131 O.A.S.I.S. HOSPITAL 750 NORTH 40TH STREET PHOENIX AZ 85008 MARICOPA 6027977700 030132 FLORENCE HOSPITAL AT ANTHEM, LLC 4545 NORTH HUNT HIGHWAY FLORENCE AZ 85132 PINAL 5204242060 030134 BANNER GOLDFIELD MEDICAL CENTER 2050 WEST SOUTHERN AVENUE APACHE JUNCTION AZ 85120 PINAL 4807333300 030136 DIGNITY HEALTH ‐ ARIZONA GENERAL HOSPITAL 7171 SOUTH 51ST AVENUE LAVEEN AZ 85339 MARICOPA 6235845100 030137 GREEN VALLEY HOSPITAL 4455 SOUTH I‐19 FRONTAGE ROAD GREEN VALLEY AZ 85614 PIMA 5203934710 03013F VA HOSP SOUTHERN ARIZONA HEALTHCARE SYSTEM 3601 S 6TH AVE TUCSON AZ 85713 PIMA 5207921450 03014F VA HOSP * PRESCOTT AZ 86301 YAVAPAI 6025555555 03019F US PHS WINSLOW INDIAN HOSP * WINSLOW AZ 86047 NAVAJO 6024444444 03020F US ARMY HOSP YUMA PROVING GROUNDS YUMA AZ 85364 YUMA 6023333333 03022E MAGMA COPPER CORP HOSP P O BOX 37 SUPERIOR AZ 85273 PINAL 03027E FRANKLIN HOSP 367 N 21ST AVE PHOENIX AZ 85009 MARICOPA 03028E ARIZONA STATE ELKS ASSN HOSP 1901 W SPEEDWAY RT 9 BOX 310 TUCSON AZ 85705 PIMA 03029E BAGDAD HOSP 1857 PARK BAGDAD AZ 86321 YAVAPAI 03030E UNIVERSITY STUDENT HLTH UNIT 3RD + CHERRY STS TUCSON AZ 85721 PIMA
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 8 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 03032E SAN MANUEL DIV HOSP‐MAGMA COPPER CO P O BOX L SAN MANUEL AZ 85631 PINAL 03033F VA HOSPITAL NORTHERN ARIZONA HEALTHCARE SYSTEM 500 HIGHWAY 89 NORTH PRESCOTT AZ 86313 YAVAPAI 5204454860
031300 WICKENBURG COMMUNITY HOSPITAL 520 ROSE LANE WICKENBURG AZ 85390 MARICOPA 9286845421 031301 BENSON HOSPITAL 450 SOUTH OCOTILLO AVENUE BENSON AZ 85602 COCHISE 5205862261 031302 NORTHERN COCHISE COMMUNITY HOSPITAL 901 WEST REX ALLEN DRIVE WILLCOX AZ 85643 COCHISE 5203843541 031304 PAGE HOSPITAL 501 NORTH NAVAJO DRIVE PAGE AZ 86040 COCONINO 9286452424 031305 HOPI HEALTH CARE CENTER HIGHWAY 264, MILEPOST 388 POLACCA AZ 86042 NAVAJO 9287376000 031307 PARKER INDIAN HEALTH CENTER 12033 AGENCY ROAD PARKER AZ 85344 LA PAZ 9286692137 031308 HUHU KAM MEMORIAL HOSPITAL 483 WEST SEED FARM ROAD SACATON AZ 85147 PINAL 5205623321 031309 SAGE MEMORIAL HOSPITAL STATE ROUTE 264 SOUTH 191 PO BOX 457 GANADO AZ 86505 APACHE 9287554559 031311 LITTLE COLORADO MEDICAL CENTER 1501 NORTH WILLIAMSON AVENUE WINSLOW AZ 86047 NAVAJO 9282894691 031312 COPPER QUEEN COMMUNITY HOSPITAL 101 COLE AVENUE BISBEE AZ 85603 COCHISE 5204326401 031313 HOLY CROSS HOSPITAL 1171 WEST TARGET RANGE ROAD NOGALES AZ 85621 SANTA CRUZ 5202853000 031314 COBRE VALLEY REGIONAL MEDICAL CENTER 5880 SOUTH HOSPITAL DRIVE GLOBE AZ 85501 GILA 9284253261 031315 WHITE MOUNTAIN REGIONAL MEDICAL CENTER 118 SOUTH MOUNTAIN AVENUE SPRINGERVILLE AZ 85938 APACHE 9283334368 031317 LA PAZ REGIONAL HOSPITAL 1200 WEST MOHAVE ROAD PARKER AZ 85344 LA PAZ 9286699201 032000 KINDRED HOSPITAL ARIZONA PHOENIX 40 EAST INDIANOLA AVENUE PHOENIX AZ 85012 MARICOPA 2147079606 032001 SELECT SPECIALTY HOSPITAL PHOENIX 350 WEST THOMAS ROAD, 3RD FLOOR PHOENIX AZ 85013 MARICOPA 6024066810 032002 KINDRED HOSPITAL ‐ TUCSON 355 NORTH WILMOT ROAD TUCSON AZ 85711 PIMA 5205844500 032004 CHG HOSPITAL TUCSON, LLC 7220 EAST ROSEWOOD STREET TUCSON AZ 85710 PIMA 5205464595 032005 SELECT SPECIALTY HOSPITAL ARIZONA 7400 EAST OSBORN RD, 3RD FLOOR SCOTTSDALE AZ 85251 MARICOPA 7179721100 032006 PROMISE HOSPITAL OF PHOENIX, INC. 433 EAST 6TH STREET MESA AZ 85203 MARICOPA 4804273001 033025 HEALTHSOUTH SCOTTSDALE REHABILITATION HOSPITAL 9630 EAST SHEA BOULEVARD SCOTTSDALE AZ 85260 MARICOPA 4805515400
033028 HEALTHSOUTH REHABILITATION INSTITUTE OF TUCSON 2650 NORTH WYATT DRIVE TUCSON AZ 85712 PIMA 5203251300
033029 HEALTHSOUTH REHABILITATION HOSPITAL OF SOUTHERN 1921 WEST HOSPITAL DRIVE TUCSON AZ 85704 PIMA 5207422800 AZ 033032 HEALTHSOUTH VALLEY OF THE SUN REHABILITATION 13460 NORTH 67TH AVENUE GLENDALE AZ 85304 MARICOPA 6238788800 033034 YUMA REHABILITATION HOSPITAL 901 WEST 24TH STREET YUMA AZ 85364 YUMA 9287265000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 9 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 033036 MOUNTAIN VALLEY REGIONAL REHABILITATION HOSPITAL 3700 NORTH WINDSONG DRIVE PRESCOTT VALLEY AZ 86314 YAVAPAI 9287598800
033037 HEALTHSOUTH EAST VALLEY REHABILITATION HOSPITAL 5652 EAST BASELINE ROAD MESA AZ 85206 MARICOPA 4805670350
033038 HONORHEALTH REHABILITATION HOSPITAL 8850 EAST PIMA CENTER PARKWAY SCOTTSDALE AZ 85258 MARICOPA 4808003900 033039 COBALT REHABILITATION HOSPITAL IV, LLC 13060 WEST BELL ROAD SURPRISE AZ 85378 MARICOPA 6234999100 033301 LOS NINOS HOSPITAL, INC. 2303 EAST THOMAS PHOENIX AZ 85016 MARICOPA 6029547311 033302 PHOENIX CHILDREN'S HOSPITAL 1919 EAST THOMAS ROAD PHOENIX AZ 85016 MARICOPA 6029331000 033303 HACIENDA CHILDREN'S HOSPITAL, INC. 610 WEST JEROME AVENUE MESA AZ 85210 MARICOPA 6022434231 034004 BANNER BEHAVIORAL HEALTH HOSPITAL 7575 EAST EARLL DRIVE SCOTTSDALE AZ 85251 MARICOPA 4809417500 034013 ST. LUKE'S BEHAVIORAL HOSPITAL, LP 1800 EAST VAN BUREN PHOENIX AZ 85006 MARICOPA 6022518535 034020 HAVEN SENIOR HORIZONS 1201 SOUTH 7TH AVENUE, SUITE 200 PHOENIX AZ 85007 MARICOPA 6232362000 034021 ARIZONA STATE HOSPITAL 2500 EAST VAN BUREN STREET PHOENIX AZ 85008 MARICOPA 6022206000 034022 SONORA BEHAVIORAL HEALTH HOSPITAL 6050 NORTH CORONA ROAD TUCSON AZ 85704 PIMA 5204698700 034023 GUIDANCE CENTER, THE 2187 NORTH VICKEY STREET FLAGSTAFF AZ 86004 COCONINO 9285271899 034024 AURORA BEHAVIORAL HEALTH SYSTEM 6015 WEST PEORIA AVENUE GLENDALE AZ 85302 MARICOPA 6233444400 034025 WINDHAVEN PSYCHIATRIC HOSPITAL 3347 NORTH WINDSONG DRIVE PRESCOTT VALLEY AZ 86314 YAVAPAI 9288997343 034026 VALLEY HOSPITAL 3550 EAST PINCHOT AVENUE PHOENIX AZ 85018 MARICOPA 6029574000 034027 CHANGEPOINT PSYCHIATRIC HOSPITAL 1920 WEST COMMERCE DRIVE LAKESIDE AZ 85929 NAVAJO 9283684110 034028 AURORA BEHAVIORAL HEALTHCARE‐TEMPE 6350 SOUTH MAPLE AVENUE TEMPE AZ 85283 MARICOPA 4803455400 034029 OASIS BEHAVIORAL HEALTH HOSPITAL 2190 NORTH GRACE BOULEVARD CHANDLER AZ 85225 MARICOPA 4809179301 034030 PALO VERDE BEHAVIORAL HEALTH 2695 NORTH CRAYCROFT ROAD TUCSON AZ 85712 PIMA 5203222888 034031 QUAIL RUN BEHAVIORAL HEALTH 2545 WEST QUAIL AVENUE PHOENIX AZ 85027 MARICOPA 6024555694 034032 COPPER SPRINGS 10550 WEST MCDOWELL ROAD AVONDALE AZ 85392 MARICOPA 4805653035 039800 UNIVERSITY MEDICAL CENTER AT THE ARIZONA HEALTH SC 1501 NORTH CAMPBELL AVENUE TUCSON AZ 85724 PIMA 5206947367
039801 MAYO CLINIC HOSPITAL 5777 EAST MAYO BOULEVARD PHOENIX AZ 85054 MARICOPA 4803421900 039802 BANNER GOOD SAMARITAN MEDICAL CENTER 1300 NORTH 12TH STREET, SUITE 404 PHOENIX AZ 85006 MARICOPA 6022392716 039803 ST JOSEPH'S HOSPITAL AND MEDICAL CENTER 350 WEST THOMAS ROAD, SUITE #500 PHOENIX AZ 85013 MARICOPA 6024063792 039804 PHOENIX CHILDRENS HOSPITAL 1919 EAST THOMAS ROAD PHOENIX AZ 85016 MARICOPA 6025461000 040001 SILOAM SPRINGS REGIONAL HOSPITAL 603 NORTH PROGRESS AVENUE SILOAM SPRINGS AR 72761 BENTON 4795244141
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 10 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 040002 JOHNSON REGIONAL MEDICAL CENTER 1100 EAST POPLAR STREET CLARKSVILLE AR 72830 JOHNSON 4797545454 040004 WASHINGTON REGIONAL MEDICAL CENTER 3215 N NORTH HILLS BOULEVARD FAYETTEVILLE AR 72703 WASHINGTON 4794635113 040007 CHI‐ST VINCENT INFIRMARY TWO ST VINCENT CIRCLE LITTLE ROCK AR 72205 PULASKI 5015523000 040010 MERCY HOSPITAL NORTHWEST ARKANSAS 2710 SOUTH RIFE MEDICAL LANE ROGERS AR 72758 BENTON 4793388000 040011 CHAMBERS MEMORIAL HOSPITAL 719 DETROIT STREET DANVILLE AR 72833 YELL 4794952241 040014 WHITE COUNTY MEDICAL CENTER 3214 EAST RACE AVENUE SEARCY AR 72143 WHITE 5012783100 040015 MENA REGIONAL HEALTH SYSTEM 311 NORTH MORROW STREET MENA AR 71953 POLK 4793946100 040016 UAMS MEDICAL CENTER 4301 WEST MARKHAM STREET MAIL SLOT 612 LITTLE ROCK AR 72205 PULASKI 5016865000 040017 NORTH ARKANSAS REGIONAL MEDICAL CENTER 620 NORTH MAIN STREET HARRISON AR 72601 BOONE 8704144000 040018 SPARKS MEDICAL CENTER ‐ VAN BUREN EAST MAIN AND SOUTH 20TH STREET VAN BUREN AR 72956 CRAWFORD 4794743401 040019 FORREST CITY MEDICAL CENTER 1601 NEWCASTLE ROAD FORREST CITY AR 72335 ST. FRANCIS 8702610000 040020 ST BERNARDS MEDICAL CENTER 225 E JACKSON JONESBORO AR 72401 CRAIGHEAD 8709724100 040022 NORTHWEST MEDICAL CENTER‐SPRINGDALE 609 WEST MAPLE AVENUE SPRINGDALE AR 72764 WASHINGTON 4797515711 040026 CHI ST. VINCENT HOSPITAL HOT SPRINGS 300 WERNER STREET HOT SPRINGS AR 71903 GARLAND 5016221000 040027 BAXTER REGIONAL MEDICAL CENTER 624 HOSPITAL DRIVE MOUNTAIN HOME AR 72653 BAXTER 8705081000 040029 CONWAY REGIONAL MEDICAL CENTER 2302 COLLEGE AVENUE CONWAY AR 72034 FAULKNER 5013293831 040036 BAPTIST HEALTH MEDICAL CENTER NORTH LITTLE ROCK 3333 SPRINGHILL DRIVE NORTH LITTLE ROCK AR 72117 PULASKI 5012023000
040039 ARKANSAS METHODIST MEDICAL CENTER 900 WEST KINGSHIGHWAY PARAGOULD AR 72450 GREENE 8702397000 040041 ST MARYS REGIONAL MEDICAL CENTER 1808 WEST MAIN STREET RUSSELLVILLE AR 72801 POPE 4799682841 040047 FIVE RIVERS MEDICAL CENTER 2801 MEDICAL CENTER DRIVE POCAHONTAS AR 72455 RANDOLPH 8708926000 040050 OUACHITA COUNTY MEDICAL CENTER 638 CALIFORNIA AVENUE CAMDEN AR 71701 OUACHITA 8708361000 040051 DREW MEMORIAL HOSPITAL 778 SCOGIN DRIVE MONTICELLO AR 71655 DREW 8703672411 040055 SPARKS REGIONAL MEDICAL CENTER 1001 TOWSON AVENUE FORT SMITH AR 72902 SEBASTIAN 4794414000 040062 MERCY HOSPITAL FORT SMITH 7301 ROGERS AVE FORT SMITH AR 72917 SEBASTIAN 4793146000 040067 MAGNOLIA HOSPITAL 101 HOSPITAL DRIVE MAGNOLIA AR 71754 COLUMBIA 8702353000 040069 GREAT RIVER MEDICAL CENTER 1520 N DIVISION STREET BLYTHEVILLE AR 72315 MISSISSIPPI 8708387300 040071 JEFFERSON REGIONAL MEDICAL CENTER 1600 WEST 40TH AVENUE PINE BLUFF AR 71603 JEFFERSON 8705417100 040072 BAPTIST HEALTH MEDICAL CENTER‐STUTTGART 1703 NORTH BUERKLE ST STUTTGART AR 72160 ARKANSAS 8706733511 040074 NORTH METRO MEDICAL CENTER 1400 BRADEN STREET JACKSONVILLE AR 72076 PULASKI 5019857000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 11 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 040076 BAPTIST HEALTH MEDICAL CENTER‐HOT SPRINGS COUNTY 1001 SCHNEIDER DRIVE MALVERN AR 72104 HOT SPRING 5013321000
040078 NATIONAL PARK MEDICAL CENTER 1910 MALVERN AVENUE HOT SPRINGS AR 71901 GARLAND 5013211000 040084 SALINE MEMORIAL HOSPITAL #1 MEDICAL PARK DRIVE BENTON AR 72015 SALINE 5017766000 040085 HELENA REGIONAL MEDICAL CENTER 1801 MARTIN LUTHER KING JR DRIVE HELENA AR 72342 PHILLIPS 8703385800 040088 MEDICAL CENTER SOUTH ARKANSAS 700 WEST GROVE STREET EL DORADO AR 71731 UNION 8708632000 04008F US AIR FORCE HOSP BLYTHEVILLE AFB BLYTHEVILLE AR 72315 MISSISSIPPI 04009F VA HOSP 1100 N COLLEGE AVE FAYETTEVILLE AR 72701 WASHINGTON 04010F VA HOSP 300 E ROOSEVELT RD LITTLE ROCK AR 72206 PULASKI 040114 BAPTIST HEALTH MEDICAL CENTER‐LITTLE ROCK 9601 INTERSTATE 630, EXIT 7 LITTLE ROCK AR 72205 PULASKI 5012022000 040118 NEA BAPTIST MEMORIAL HOSPITAL 4800 EAST JOHNSON AVENUE JONESBORO AR 72401 CRAIGHEAD 8709727000 040119 WHITE RIVER MEDICAL CENTER 1710 HARRISON STREET BATESVILLE AR 72503 INDEPENDENCE 8702621200 04011F VA HOSP 300 E ROOSEVELT RD NORTH LITTLE ROCK AR 72114 PULASKI 040132 LEVI HOSPITAL 300 PROSPECT AVE HOT SPRINGS AR 71901 GARLAND 5016241281 040134 ARKANSAS HEART HOSPITAL, LLC 1701 S SHACKLEFORD ROAD LITTLE ROCK AR 72211 PULASKI 5012197000 040137 ST VINCENT MEDICAL CENTER/NORTH 2215 WILDWOOD AVENUE SHERWOOD AR 72120 PULASKI 5015527100 04013F US AIR FORCE DISPENSARY LITTLE ROCK AR 72201 PULASKI 040147 ARKANSAS SURGICAL HOSPITAL 5201 NORTH SHORE DRIVE NO LITTLE ROCK AR 72118 PULASKI 5017488000 040152 NORTHWEST HEALTH PHYSICIANS SPECIALTY HOSPITAL 3873 NORTH PARKVIEW DRIVE FAYETTEVILLE AR 72703 WASHINGTON 4795717002
040153 WADLEY REGIONAL MEDICAL CENTER AT HOPE 2001 SOUTH MAIN HOPE AR 71801 HEMPSTEAD 8707223800 04020E ARKANSAS CHILDRENS COLONY HOSP CONWAY AR 72032 FAULKNER 04022E SMITH HOSP BRADFORD AR 72020 WHITE 041300 NORTH LOGAN MERCY HOSPITAL 500 EAST ACADEMY PARIS AR 72855 LOGAN 4799636101 041302 RIVER VALLEY MEDICAL CENTER 200 NORTH THIRD STREET DARDANELLE AR 72834 YELL 4792294677 041303 MERCY HOSPITAL TURNER MEMORIAL 801 WEST RIVER STREET OZARK AR 72949 FRANKLIN 4796674138 041304 EUREKA SPRINGS HOSPITAL, LLC 24 NORRIS STREET EUREKA SPRINGS AR 72632 CARROLL 4792537400 041305 MERCY HOSPITAL WALDRON 1341 WEST SIXTH STREET WALDRON AR 72958 SCOTT 4796374135 041306 COMMUNITY MEDICAL CENTER IZARD COUNTY 103 GRASSE STREET CALICO ROCK AR 72519 IZARD 8702973726 041307 CROSSRIDGE COMMUNITY HOSPITAL 310 SOUTH FALLS BOULEVARD WYNNE AR 72396 CROSS 8702383300 041308 MCGEHEE HOSPITAL 900 SOUTH THIRD STREET MCGEHEE AR 71654 DESHA 8702225600
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 12 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 041309 LAWRENCE MEMORIAL HOSPITAL 1309 WEST MAIN WALNUT RIDGE AR 72476 LAWRENCE 8708861200 041310 STONE COUNTY MEDICAL CENTER 2106 EAST MAIN STREET MOUNTAIN VIEW AR 72560 STONE 8702694361 041311 HOWARD MEMORIAL HOSPITAL 130 MEDICAL CIRCLE NASHVILLE AR 71852 HOWARD 8708454400 041312 BAPTIST HEALTH MEDICAL CENTER HEBER SPINGS 1800 BYPASS ROAD HEBER SPRINGS AR 72543 CLEBURNE 5018873000 041313 OZARK HEALTH 2500 HIGHWAY 65 SOUTH CLINTON AR 72031 VAN BUREN 5017457000 041314 DEWITT HOSPITAL & NURSING HOME, INC 1641 WHITEHEAD DRIVE DE WITT AR 72042 ARKANSAS 8709463571 041316 SOUTH MISSISSISSPI COUNTY REGIONAL MEDICAL CENTER 611 WEST LEE AVENUE OSCEOLA AR 72370 MISSISSIPPI 8705637000
041317 DALLAS COUNTY MEDICAL CENTER 201 CLIFTON STREET FORDYCE AR 71742 DALLAS 8703526300 041318 MERCY HOSPITAL BOONEVILLE 880 WEST MAIN BOONEVILLE AR 72927 LOGAN 4796752800 041319 DE QUEEN MEDICAL CENTER, INC 1306 WEST COLLIN RAYE DRIVE DE QUEEN AR 71832 SEVIER 8705844111 041320 LITTLE RIVER MEMORIAL HOSPITAL 451 WEST LOCKE STREET ASHDOWN AR 71822 LITTLE RIVER 8708985011 041321 BAPTIST HEALTH MEDICAL CENTER‐ARKADELPHIA 3050 TWIN RIVERS DRIVE ARKADELPHIA AR 71923 CLARK 8702452622 041322 FULTON COUNTY HOSPITAL 679 NORTH MAIN STREET SALEM AR 72576 FULTON 8708952691 041323 ASHLEY COUNTY MEDICAL CENTER 1015 UNITY ROAD CROSSETT AR 71635 ASHLEY 8703644111 041324 CHI ST VINCENT MORRILTON #4 HOSPITAL DRIVE MORRILTON AR 72110 CONWAY 5019772300 041326 DELTA MEMORIAL HOSPITAL 811 HIGHWAY 65 SOUTH DUMAS AR 71639 DESHA 8703824303 041327 BRADLEY COUNTY MEDICAL CENTER 404 SOUTH BRADLEY STREET WARREN AR 71671 BRADLEY 8702263731 041328 CHICOT MEMORIAL MEDICAL CENTER 2729 SOUTH HIGHWAY 65 & 82 LAKE VILLAGE AR 71653 CHICOT 8702655351 041329 MERCY HOSPITAL BERRYVILLE 214 CARTER STREET BERRYVILLE AR 72616 CARROLL 8704233355 041330 PIGGOTT COMMUNITY HOSPITAL 1206 GORDON DUCKWORTH DRIVE PIGGOTT AR 72454 CLAY 8705983881 041331 OZARKS COMMUNITY HOSPITAL OF GRAVETTE 1101 JACKSON STREET SW GRAVETTE AR 72736 BENTON 4797875291 042004 CHRISTUS DUBUIS HOSPITAL OF HOT SPRINGS 300 WERNER STREET, 3RD FLOOR HOT SPRINGS AR 71913 GARLAND 5016094333 042006 SELECT SPECIALITY HOSPITAL‐FORT SMITH INC 1001 TOWSON AVENUE FORT SMITH AR 72901 SEBASTIAN 4794413960 042008 CHRISTUS DUBUIS HOSPITAL OF FORT SMITH 7301 ROGERS AVENUE, # 4FORT SMITH AR 72903 SEBASTIAN 4793144900 042009 REGENCY HOSPITAL OF NORTHWEST ARKANSAS 609 WEST MAPLE AVENUE SPRINGDALE AR 72764 WASHINGTON 4797137000 042010 CORNERSTONE HOSPITAL LITTLE ROCK 2 ST VINCENT CIRCLE, 6TH FLOOR LITTLE ROCK AR 72205 PULASKI 5019857467 042011 ADVANCED CARE HOSPITAL WHITE COUNTY 1200 SOUTH MAIN STREET SEARCY AR 72143 WHITE 5012783155 042012 BAPTIST HEALTH EXTENDED CARE HOSPITAL‐LR INC 9601 BAPTIST HEALTH DRIVE, 1OTH FLOOR LITTLE ROCK AR 72205 PULASKI 5012026000 043026 BAPTIST HEALTH REHABILITATION INSTITUTE 9601 BAPTIST HEALTH DRIVE LITTLE ROCK AR 72205 PULASKI 5012027578
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 13 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 043028 HEALTHSOUTH REHABILITATION HOSPITAL OF FORT SMITH 1401 SOUTH J STREET FORT SMITH AR 72901 SEBASTIAN 4797853300
043029 HEALTHSOUTH REHABILITATION HOSPITAL OF JONESBORO 1201 FLEMING AVE JONESBORO AR 72401 CRAIGHEAD 8709320440
043031 ST VINCENT REHABILITATION HOSPITAL 2201 WILDWOOD AVENUE SHERWOOD AR 72120 PULASKI 5018341800 043032 HEALTHSOUTH REHAB HOSP IN PART W/WASHINGTON 153 E MONTE PAINTER DRIVE FAYETTEVILLE AR 72703 WASHINGTON 4794442200 REGION 043033 CONWAY REGIONAL REHABILITATION HOSPITAL 2210 ROBINSON STREET CONWAY AR 72034 FAULKNER 5019323500 043034 SOUTHEAST REHABILITATION HOSPITAL 2729 A HIGHWAY 65 & 82 SOUTH LAKE VILLAGE AR 71653 CHICOT 8702655343 043035 CHI ST VINCENT HOT SPRINGS REHABILITATION HOSPITAL 300 WERNER STREET HOT SPRINGS AR 71913 GARLAND 5016221887
043300 ARKANSAS CHILDREN'S HOSPITAL 1 CHILDREN'S WAY, SLOT 301 LITTLE ROCK AR 72202 PULASKI 5013641100 044004 VANTAGE POINT OF NORTHWEST ARKANSAS 4253 CROSSOVER ROAD FAYETTEVILLE AR 72703 WASHINGTON 4795215731 044005 BRIDGEWAY INC, THE 21 BRIDGEWAY ROAD NORTH LITTLE ROCK AR 72113 PULASKI 5017711500 044006 VALLEY BEHAVIORAL HEALTH SYSTEM 10301 MAYO DRIVE BARLING AR 72923 SEBASTIAN 4794945700 044007 RIVENDELL BEHAVIORAL HEALTH SERVICES OF ARKANSAS 100 RIVENDELL DRIVE BENTON AR 72019 SALINE 5013161255
044011 ARKANSAS STATE HOSPITAL 305 S PALM STREET LITTLE ROCK AR 72205 PULASKI 5016869000 044013 PINNACLE POINTE HOSPITAL 11501 FINANCIAL CENTRE PARKWAY LITTLE ROCK AR 72211 PULASKI 5012233322 044017 UNITED METHODIST BEHAVIORAL HOSPITAL 1601 MURPHY DRIVE MAUMELLE AR 72113 PULASKI 5018033388 044019 SPRINGWOODS BEHAVIORAL HEALTH SERVICES 1955 WEST TRUCKER'S DRIVE FAYETTEVILLE AR 72704 WASHINGTON 4799736000 044020 RIVERVIEW BEHAVIORAL HEALTH 701 ARKANSAS BOULEVARD SUITE 300 TEXARKANA AR 71854 MILLER 8707725028 044021 OAKRIDGE BEHAVIORAL CENTER 600 NORTH 7TH STREET WEST MEMPHIS AR 72301 CRITTENDEN 8703944113 049801 ARKANSAS CHILDREN'S HOSPITAL 800 MARSHALL STREET LITTLE ROCK AR 72202 PULASKI 5013641847 049802 BAPTIST HEALTH MEDICAL CENTER 9601 INTERSTATE 630, EXIT 7 LITTLE ROCK AR 72205 PULASKI 5012021500 049803 UNIVERSITY OF ARKANSAS MEDICAL SCIENCES‐ TRANSPLANT SURGERY SLOT 520‐4, 4301 W MARKHAM LITTLE ROCK AR 72205 PULASKI 5016031074 TRANSPLANT 050002 ST ROSE HOSPITAL 27200 CALAROGA AVE HAYWARD CA 94545 ALAMEDA 5107826200 050006 ST JOSEPH HOSPITAL 2700 DOLBEER ST EUREKA CA 95501 HUMBOLDT 7074458121 050007 MILLS‐PENINSULA MEDICAL CENTER 1501 TROUSDALE DRIVE BURLINGAME CA 94010 SAN MATEO 6506965270 050008 CALIFORNIA PACIFIC MEDICAL CTR‐DAVIES CAMPUS HOSP 601 DUBOCE AVE SAN FRANCISCO CA 94117 4156006000
050009 QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS ST NAPA CA 94558 NAPA 7072524411
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 14 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050013 ST HELENA HOSPITAL 10 WOODLAND ROAD SAINT HELENA CA 94574 NAPA 7079633611 050014 SUTTER AMADOR HOSPITAL 200 MISSION BLVD JACKSON CA 95642 AMADOR 2092237500 050016 MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDE 345 S HALCYON RD ARROYO GRANDE CA 93420 SAN LUIS OBISPO 8054894261
050017 MERCY GENERAL HOSPITAL 4001 J ST SACRAMENTO CA 95819 SACRAMENTO 9164534545 050018 PACIFIC ALLIANCE MEDICAL CENTER 531 W COLLEGE ST LOS ANGELES CA 90012 LOS ANGELES 2136248411 05001E CALIFORNIA STATE POLYTECHNIC COL HOSP UNIVERSITY CAMPUS SAN LUIS OBISPO CA 93401 SAN LUIS OBISPO 8057561111 050022 RIVERSIDE COMMUNITY HOSPITAL 4445 MAGNOLIA AVENUE RIVERSIDE CA 92501 RIVERSIDE 9517883000 050024 PARADISE VALLEY HOSPITAL 2400 EAST 4TH ST NATIONAL CITY CA 91950 SAN DIEGO 6194704321 050025 UNIVERSITY OF CALIFORNIA SAN DIEGO MEDICAL CENTER 200 WEST ARBOR DRIVE SAN DIEGO CA 92103 SAN DIEGO 6195436222
050026 GROSSMONT HOSPITAL 5555 GROSSMONT CENTER DRIVE BOX 58 LA MESA CA 91942 SAN DIEGO 6194650711 050028 MAD RIVER COMMUNITY HOSPITAL 3800 JANES RD ARCATA CA 95521 HUMBOLDT 7078223621 050030 OROVILLE HOSPITAL 2767 OLIVE HIGHWAY OROVILLE CA 95966 BUTTE 5305338500 050036 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH ST BOX BAKERSFIELD CA 93301 KERN 6613271792 050038 SANTA CLARA VALLEY MEDICAL CENTER 751 SOUTH BASCOM AVENUE SAN JOSE CA 95128 SANTA CLARA 4088855000 050039 ENLOE MEDICAL CENTER 1531 ESPLANADE CHICO CA 95926 BUTTE 5303327300 050040 LAC/OLIVE VIEW‐UCLA MEDICAL CENTER 14445 OLIVE VIEW DRIVE SYLMAR CA 91342 LOS ANGELES 8183641555 050042 ST ELIZABETH COMMUNITY HOSPITAL 2550 SISTER MARY COLUMBA DRIVE RED BLUFF CA 96080 TEHAMA 5305298012 050043 ALTA BATES SUMMIT MEDICAL CENTER 350 HAWTHORNE AVENUE OAKLAND CA 94609 ALAMEDA 5106554000 050045 EL CENTRO REGIONAL MEDICAL CENTER 1415 ROSS AVENUE EL CENTRO CA 92243 IMPERIAL 7603397100 050047 CALIFORNIA PACIFIC MEDICAL CTR‐PACIFIC CAMPUS HOSP 2333 BUCHANAN STREET SAN FRANCISCO CA 94115 4156006000
050054 SAN GORGONIO MEMORIAL HOSPITAL 600 NORTH HIGHLAND SPRINGS AVENUE BANNING CA 92220 RIVERSIDE 9518451121 050055 CALIFORNIA PACIFIC MEDICAL CTR ‐ ST. LUKE'S CAMPUS 3555 CESAR CHAVEZ STREET SAN FRANCISCO CA 94110 4156416562
050056 ANTELOPE VALLEY HOSPITAL 1600 W AVE J LANCASTER CA 93534 LOS ANGELES 6619495000 050057 KAWEAH DELTA MEDICAL CENTER 400 W MINERAL KING AVE VISALIA CA 93291 TULARE 5596242000 050058 GLENDALE MEM HOSPITAL & HLTH CENTER 1420 S CENTRAL AVE GLENDALE CA 91204 LOS ANGELES 8185021900 050060 COMMUNITY REGIONAL MEDICAL CENTER 2823 FRESNO STREET FRESNO CA 93721 FRESNO 5594596000 050063 HOLLYWOOD PRESBYTERIAN MEDICAL CENTER 1300 N VERMONT AVE LOS ANGELES CA 90027 LOS ANGELES 2134133000 050067 OAK VALLEY HOSPITAL DISTRICT 350 S OAK AVE OAKDALE CA 95361 STANISLAUS 2098473011
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 15 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050069 ST JOSEPH HOSPITAL 1100 WEST STEWART DR ORANGE CA 92868 ORANGE 7146339111 050070 KAISER FOUNDATION HOSPITAL ‐ SOUTH SAN FRANCISCO 1200 EL CAMINO REAL SOUTH SAN FRANCISCO CA 94080 SAN MATEO 6507423200
050071 KAISER FOUNDATION HOSPITAL‐SANTA CLARA 700 LAWRENCE EXPRESSWAY SANTA CLARA CA 95051 SANTA CLARA 4082366400 050072 KAISER FOUNDATION HOSPITAL ‐ WALNUT CREEK 1425 S MAIN STREET WALNUT CREEK CA 94596 CONTRA COSTA 9252954000 050073 KAISER FOUNDATION HOSPITAL AND REHAB CENTER 975 SERENO DR VALLEJO CA 94589 SOLANO 7076511000 050075 KAISER FOUNDATION HOSPITAL ‐ OAKLAND/RICHMOND 275 W MACARTHUR BOULEVARD OAKLAND CA 94611 ALAMEDA 5107521000
050076 KAISER FOUNDATION HOSPITAL ‐ SAN FRANCISCO 2425 GEARY BLVD SAN FRANCISCO CA 94115 4158332646 050077 SCRIPPS MERCY HOSPITAL 4077 5TH AVE SAN DIEGO CA 92103 SAN DIEGO 6192948111 050078 PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO 1300 W 7TH ST SAN PEDRO CA 90732 LOS ANGELES 3108323311
05007F US AIR FORCE HOSP BEALE AFB MARYSVILLE CA 95903 YUBA 9995551212 050082 ST JOHNS REGIONAL MEDICAL CENTER 1600 N ROSE AVE OXNARD CA 93030 VENTURA 8059882500 050084 ST JOSEPH'S MEDICAL CENTER OF STOCKTON 1800 N CALIFORNIA ST STOCKTON CA 95204 SAN JOAQUIN 2099432000 050089 COMMUNITY HOSPITAL OF SAN BERNARDINO 1805 MEDICAL CENTER DRIVE SAN BERNARDINO CA 92411 SAN BERNARDINO 9098876333 050090 SONOMA VALLEY HOSPITAL 347 ANDRIEUX ST SONOMA CA 95476 SONOMA 7079355000 050091 COMMUNITY HOSPITAL OF HUNTINGTON PARK 2623 E SLAUSON AVE HUNTINGTON PARK CA 90255 LOS ANGELES 3235831931 050093 SAINT AGNES MEDICAL CENTER 1303 E HERNDON AVE FRESNO CA 93710 FRESNO 5594503000 050096 WEST COVINA MEDICAL CENTER 725 S ORANGE AVE WEST COVINA CA 91790 LOS ANGELES 6263388481 050099 SAN ANTONIO REGIONAL HOSPITAL 999 SAN BERNARDINO ROAD UPLAND CA 91786 SAN BERNARDINO 7149852811 05009F US AIR FORCE HOSP EDWARDS AFB EDWARDS CA 93523 KERN 9995551212 050100 SHARP MEMORIAL HOSPITAL 7901 FROST ST SAN DIEGO CA 92123 SAN DIEGO 8589393400 050101 SUTTER SOLANO MEDICAL CENTER 300 HOSPITAL DR VALLEJO CA 94589 SOLANO 7075545280 050102 PARKVIEW COMMUNITY HOSPITAL MEDICAL CENTER 3865 JACKSON STREET RIVERSIDE CA 92503 RIVERSIDE 9516882211 050103 WHITE MEMORIAL MEDICAL CENTER 1720 E CESAR AVENUE LOS ANGELES CA 90033 LOS ANGELES 3232685000 050104 SAINT FRANCIS MEDICAL CENTER 3630 EAST IMPERIAL HIGHWAY LYNWOOD CA 90262 LOS ANGELES 3109008900 050107 MARIAN REGIONAL MEDICAL CENTER 1400 E CHURCH ST SANTA MARIA CA 93454 SANTA BARBARA 8057393000 050108 SUTTER MEDICAL CENTER, SACRAMENTO 2825 CAPITOL AVENUE SACRAMENTO CA 95816 SACRAMENTO 9167338999 05010F US AIR FORCE HOSP GEORGE AFB VICTORVILLE CA 92393 SAN BERNARDINO 9995551212 050110 LOMPOC VALLEY MEDICAL CENTER 1515 E OCEAN AVENUE LOMPOC CA 93436 SANTA BARBARA 8057373300
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 16 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050112 SANTA MONICA ‐ UCLA MED CTR & ORTHOPAEDIC 1250 16TH STREET SANTA MONICA CA 90404 LOS ANGELES 3103194000 HOSPITAL 050113 SAN MATEO MEDICAL CENTER 222 W 39TH AVE SAN MATEO CA 94403 SAN MATEO 6505732222 050115 PALOMAR HEALTH DOWNTOWN CAMPUS 555 E VALLEY PARKWAY ESCONDIDO CA 92025 SAN DIEGO 7607393000 050116 NORTHRIDGE HOSPITAL MEDICAL CENTER 18300 ROSCOE BLVD NORTHRIDGE CA 91325 LOS ANGELES 8188858500 050118 DOCTORS HOSPITAL OF MANTECA 1205 E NORTH STREET MANTECA CA 95336 SAN JOAQUIN 2098233111 05011F US AIR FORCE HOSP HAMILTON AFB NOVATO CA 94945 MARIN 9995551212 050121 ADVENTIST MEDICAL CENTER 115 MALL DRIVE HANFORD CA 93230 KINGS 2094107200 050122 DAMERON HOSPITAL 525 WEST ACACIA STREET STOCKTON CA 95203 SAN JOAQUIN 2099445550 050124 USC VERDUGO HILLS HOSPITAL 1812 VERDUGO BLVD GLENDALE CA 91209 LOS ANGELES 8187907100 050125 REGIONAL MEDICAL CENTER OF SAN JOSE 225 N JACKSON AVENUE SAN JOSE CA 95116 SANTA CLARA 4082595000 050126 VALLEY PRESBYTERIAN HOSPITAL 15107 VANOWEN ST VAN NUYS CA 91406 LOS ANGELES 8187826600 050127 WOODLAND MEMORIAL HOSPITAL 1325 COTTONWOOD STREET WOODLAND CA 95695 YOLO 5306623961 050128 TRI‐CITY MEDICAL CENTER 4002 VISTA WAY OCEANSIDE CA 92056 SAN DIEGO 7607248411 050129 ST BERNARDINE MEDICAL CENTER 2101 N WATERMAN AVE SAN BERNARDINO CA 92404 SAN BERNARDINO 9098838711 05012F US AIR FORCE HOSP MARCH AFB RIVERSIDE CA 92508 RIVERSIDE 9995551212 050131 NOVATO COMMUNITY HOSPITAL 180 ROWLAND WAY NOVATO CA 94945 MARIN 4152091300 050132 SAN GABRIEL VALLEY MEDICAL CENTER 438 W LAS TUNAS DRIVE SAN GABRIEL CA 91776 LOS ANGELES 6262895454 050133 RIDEOUT MEMORIAL HOSPITAL 726 4TH ST MARYSVILLE CA 95901 YUBA 5307494300 050135 SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD 6245 DE LONGPRE AVE HOLLYWOOD CA 90028 LOS ANGELES 3234622271 050136 PETALUMA VALLEY HOSPITAL 400 N MCDOWELL BLVD PETALUMA CA 94954 SONOMA 7077781111 050137 KAISER FOUNDATION HOSPITAL ‐ PANORAMA CITY 13652 CANTARA ST PANORAMA CITY CA 91402 LOS ANGELES 8183753333 050138 KAISER FOUNDATION HOSPITAL ‐ LOS ANGELES 4867 SUNSET BLVD LOS ANGELES CA 90027 LOS ANGELES 3237834011 050139 KAISER FOUNDATION HOSPITAL ‐ DOWNEY 9333 IMPERIAL HIGHWAY DOWNEY CA 90242 LOS ANGELES 5624616007 05013F US AIR FORCE HOSP MATHER AFB MATHER CA 95655 SACRAMENTO 9995551212 050140 KAISER FOUNDATION HOSPITAL FONTANA 9961 SIERRA AVE FONTANA CA 92335 SAN BERNARDINO 9094275500 050145 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA 23625 W R HOLMAN HIGHWAY MONTEREY CA 93940 MONTEREY 8316245311
050146 CITY OF HOPE HELFORD CLINICAL RESEARCH HOSPITAL 1500 E DUARTE ROAD DUARTE CA 91010 LOS ANGELES 6263598111
050149 CALIFORNIA HOSPITAL MEDICAL CENTER LA 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 LOS ANGELES 2137482411
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 17 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 05014F US AIR FORCE HOSP NORTON AFB SAN BERNARDINO CA 92408 SAN BERNARDINO 9995551212 050150 SIERRA NEVADA MEMORIAL HOSPITAL 155 GLASSON WAY GRASS VALLEY CA 95945 NEVADA 5302746000 050152 SAINT FRANCIS MEMORIAL HOSPITAL 900 HYDE ST SAN FRANCISCO CA 94109 4153536000 050153 O'CONNOR HOSPITAL 2105 FOREST AVENUE SAN JOSE CA 95128 SANTA CLARA 4089472500 050158 ENCINO HOSPITAL MEDICAL CENTER 16237 VENTURA BLVD ENCINO CA 91436 LOS ANGELES 8189955000 050159 VENTURA COUNTY MEDICAL CENTER 3291 LOMA VISTA RD VENTURA CA 93003 VENTURA 8056526075 05015F US AIR FORCE HOSP TRAVIS AIRFORCE BASE FAIRFIELD CA 94535 SOLANO 9995551212 050167 SAN JOAQUIN GENERAL HOSPITAL 500 W HOSPITAL ROAD FRENCH CAMP CA 95231 SAN JOAQUIN 2094686000 050168 ST JUDE MEDICAL CENTER 101 E VALENCIA MESA DRIVE FULLERTON CA 92835 ORANGE 7149923000 050169 PRESBYTERIAN INTERCOMMUNITY HOSPITAL 12401 WASHINGTON BLVD WHITTIER CA 90602 LOS ANGELES 5266980811 05016F US AIR FORCE HOSP VANDENBERG AFB LOMPOC CA 93437 SANTA BARBARA 9995551212 050174 SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DR SANTA ROSA CA 95405 SONOMA 7075255300 050179 EMANUEL MEDICAL CENTER 825 DELBON AVE TURLOCK CA 95382 STANISLAUS 2096674200 05017F US ARMY HOSP FT MACARTHUR FORT MACARTHUR CA 90731 LOS ANGELES 9995551212 050180 JOHN MUIR MEDICAL CENTER ‐ WALNUT CREEK CAMPUS 1601 YGNACIO VALLEY RD WALNUT CREEK CA 94598 CONTRA COSTA 9259393000
050189 GEORGE L MEE MEMORIAL HOSPITAL 300 CANAL STREET KING CITY CA 93930 MONTEREY 8313856000 05018F US ARMY HOSP MARINA CA 93933 MONTEREY 9995551212 050191 ST MARY MEDICAL CENTER 1050 LINDEN AVE LONG BEACH CA 90813 LOS ANGELES 5624919000 050192 ADVENTIST MEDICAL CENTER ‐ REEDLEY 372 W CYPRESS AVE REEDLEY CA 93654 FRESNO 5596388155 050194 WATSONVILLE COMMUNITY HOSPITAL 75 NIELSON STREET WATSONVILLE CA 95076 SANTA CRUZ 8317244741 050195 WASHINGTON HOSPITAL 2000 MOWRY AVE FREMONT CA 94538 ALAMEDA 5107971111 050196 ADVENTIST MEDICAL CENTER ‐ CENTRAL VALLEY 1025 N DOUTY ST HANFORD CA 93230 KINGS 5595832100 050197 SEQUOIA HOSPITAL 170 ALAMEDA DE LAS PULGAS REDWOOD CITY CA 94062 SAN MATEO 6503675551 050204 PALMDALE REGIONAL MEDICAL CENTER 38600 MEDICAL CENTER DRIVE PALMDALE CA 93552 LOS ANGELES 6613825000 050205 GLENDORA COMMUNITY HOSPITAL 150 WEST ROUTE 66 GLENDORA CA 91740 LOS ANGELES 6263350231 05020F US NAVAL HOSP CAMP PENDLETON OCEANSIDE CA 92055 SAN DIEGO 9995551212 050211 ALAMEDA HOSPITAL 2070 CLINTON AVENUE ALAMEDA CA 94501 ALAMEDA 5105223700 05021F US NAVAL HOSP 8750 MOUNTAIN BLVD OAKLAND CA 94614 ALAMEDA 9995551212 050222 SHARP CHULA VISTA MEDICAL CENTER 751 MEDICAL CENTER COURT CHULA VISTA CA 91911 SAN DIEGO 6195025800
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 18 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050224 HOAG MEMORIAL HOSPITAL PRESBYTERIAN ONE HOAG DRIVE NEWPORT BEACH CA 92663 ORANGE 9497644624 050225 FEATHER RIVER HOSPITAL 5974 PENTZ ROAD PARADISE CA 95969 BUTTE 5308779361 050226 AHMC ANAHEIM REGIONAL MEDICAL CENTER 1111 W LA PALMA AVENUE ANAHEIM CA 92801 ORANGE 7147741450 050228 SAN FRANCISCO GENERAL HOSPITAL 1001 POTRERO AVENUE SAN FRANCISCO CA 94110 4152068000 05022F US NAVAL HOSP PARK BLVD SAN DIEGO CA 92134 SAN DIEGO 9995551212 050230 GARDEN GROVE HOSPITAL & MEDICAL CENTER 12601 GARDEN GROVE BLVD GARDEN GROVE CA 92843 ORANGE 7145375160 050231 POMONA VALLEY HOSPITAL MEDICAL CENTER 1798 N GAREY AVE POMONA CA 91767 LOS ANGELES 9098659500 050232 FRENCH HOSPITAL MEDICAL CENTER 1911 JOHNSON AVE SAN LUIS OBISPO CA 93401 SAN LUIS OBISPO 8055435353 050234 SHARP CORONADO HOSPITAL AND HLTHCR CTR 250 PROSPECT PLACE CORONADO CA 92118 SAN DIEGO 6194356251 050235 PROVIDENCE SAINT JOSEPH MEDICAL CTR 501 SOUTH BUENA VISTA BURBANK CA 91505 LOS ANGELES 8188435111 050236 SIMI VALLEY HOSPITAL & HEALTH CARE SERVICES 2975 N SYCAMORE DR SIMI VALLEY CA 93065 VENTURA 8059556000 050238 METHODIST HOSPITAL OF SOUTHERN CA 300 W HUNTINGTON DR ARCADIA CA 91006 LOS ANGELES 6264454441 050239 GLENDALE ADVENTIST MEDICAL CENTER 1509 E WILSON TERRACE GLENDALE CA 91206 LOS ANGELES 8184098202 050242 DOMINICAN HOSPITAL 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 SANTA CRUZ 8314627700 050243 DESERT REGIONAL MEDICAL CENTER 1150 NORTH INDIAN CANYON DRIVE PALM SPRINGS CA 92262 RIVERSIDE 7603236511 050245 ARROWHEAD REGIONAL MEDICAL CENTER 400 NORTH PEPPER AVENUE COLTON CA 92324 SAN BERNARDINO 9095801000 050248 NATIVIDAD MEDICAL CENTER 1441 CONSTITUTION BOULEVARD SALINAS CA 93906 MONTEREY 8317554195 05024F FEDERAL CORRECTIONAL INSTITUTE HOSP LOMPOC CA 93436 SANTA BARBARA 9995551212 050254 MARSHALL MEDICAL CENTER 1100 MARSHALL WAY PLACERVILLE CA 95667 EL DORADO 5306221441 050257 GOOD SAMARITAN HOSPITAL 901 OLIVE DRIVE BAKERSFIELD CA 93308 KERN 6613994461 05025F VA HOSP 2615 EAST CLINTON AVENUE FRESNO CA 93703 FRESNO 5592256100 050261 SIERRA VIEW MEDICAL CENTER 465 W PUTNAM AVE PORTERVILLE CA 93257 TULARE 5597841110 050262 RONALD REAGAN U C L A MEDICAL CENTER 757 WESTWOOD PLAZA LOS ANGELES CA 90095 LOS ANGELES 3108256301 05026F VA HOSP LIVERMORE 4951 ARROYO ROAD LIVERMORE CA 94550 ALAMEDA 9253734700 050272 REDLANDS COMMUNITY HOSPITAL 350 TERRACINA BLVD REDLANDS CA 92373 SAN BERNARDINO 9093355500 050276 CONTRA COSTA REGIONAL MEDICAL CENTER 2500 ALHAMBRA AVENUE MARTINEZ CA 94553 CONTRA COSTA 9253705000 050278 PROVIDENCE HOLY CROSS MEDICAL CENTER 15031 RINALDI ST MISSION HILLS CA 91346 LOS ANGELES 8183658051 050279 HI‐DESERT MEDICAL CENTER 6601 WHITE FEATHER ROAD JOSHUA TREE CA 92252 SAN BERNARDINO 7603663711 05027F VA HOSP 5901 E 7TH ST LONG BEACH CA 90822 LOS ANGELES 5628268000 050280 MERCY MEDICAL CENTER REDDING 2175 ROSALINE AVE, CLAIRMONT HGTS REDDING CA 96001 SHASTA 5302256102
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 19 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050281 ALHAMBRA HOSPITAL MEDICAL CENTER 100 S RAYMOND AVE ALHAMBRA CA 91801 LOS ANGELES 6265701606 050283 VALLEYCARE MEDICAL CENTER 5555 WEST LAS POSITAS BOULEVARD PLEASANTON CA 94588 ALAMEDA 9254477000 050289 SETON MEDICAL CENTER 1900 SULLIVAN AVENUE DALY CITY CA 94015 SAN MATEO 6509924000 05028F VA HOSPS‐BRENTWOOD & WADSWORTH WILSHIRE & SAWTELLE BLVDS LOS ANGELES CA 90073 LOS ANGELES 9995551212 050290 PROVIDENCE SAINT JOHN'S HEALTH CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 LOS ANGELES 3108295511 050291 SUTTER SANTA ROSA REGIONAL HOSPITAL 30 MARK WEST SPRINGS ROAD SANTA ROSA CA 95403 SONOMA 7075764000 050292 RIVERSIDE UNIVERSITY HEALTH SYSTEM‐MEDICAL CENTER 26520 CACTUS AVENUE MORENO VALLEY CA 92555 RIVERSIDE 9514864000
050295 MERCY HOSPITAL 2215 TRUXTUN AVENUE BAKERSFIELD CA 93301 KERN 6616325000 050296 HAZEL HAWKINS MEMORIAL HOSPITAL 911 SUNSET DRIVE HOLLISTER CA 95023 SAN BENITO 8316375711 050298 BARSTOW COMMUNITY HOSPITAL 820 E MOUNTAIN VIEW STREET BARSTOW CA 92311 SAN BERNARDINO 7602561761 05029F WADSWORTH HOSP LOS ANGELES CA 90025 LOS ANGELES 9995551212 050300 ST MARY MEDICAL CENTER 18300 HIGHWAY 18 APPLE VALLEY CA 92307 SAN BERNARDINO 7602422311 050301 UKIAH VALLEY MEDICAL CENTER 275 HOSPITAL DRIVE UKIAH CA 95482 MENDOCINO 7074623111 050305 ALTA BATES SUMMIT MEDICAL CENTER ‐ ALTA BATES CAMP 2450 ASHBY AVE BERKELEY CA 94705 ALAMEDA 5102044444
050308 EL CAMINO HOSPITAL 2500 GRANT ROAD MOUNTAIN VIEW CA 94040 SANTA CLARA 6509407000 050309 SUTTER ROSEVILLE MEDICAL CENTER ONE MEDICAL PLAZA ROSEVILLE CA 95661 PLACER 9167811000 05030F VA HOSP 150 MUIR RD MARTINEZ CA 94553 CONTRA COSTA 9253722000 050313 SUTTER TRACY COMMUNITY HOSPITAL 1420 N TRACY BLVD TRACY CA 95376 SAN JOAQUIN 2098351500 050315 KERN MEDICAL CENTER 1700 MOUNT VERNON AVENUE BAKERSFIELD CA 93306 KERN 6613262000 05031F VA HOSP 3801 MIRANDA AVENUE PALO ALTO CA 94304 SANTA CLARA 6504935000 050320 HIGHLAND HOSPITAL 1411 E 31ST STREET OAKLAND CA 94602 ALAMEDA 5104374800 050324 SCRIPPS MEMORIAL HOSPITAL LA JOLLA 9888 GENESEE AVENUE LA JOLLA CA 92037 SAN DIEGO 8586264123 050327 LOMA LINDA UNIVERSITY MEDICAL CENTER 11234 ANDERSON ST LOMA LINDA CA 92354 SAN BERNARDINO 9095584000 050329 CORONA REGIONAL MEDICAL CENTER 800 SOUTH MAIN STREET CORONA CA 92882 RIVERSIDE 9517374343 05032F VA HOSP 13000 SAYRE ST KAGEL CANYON CA 91342 LOS ANGELES 9995551212 050334 SALINAS VALLEY MEMORIAL HOSPITAL 450 EAST ROMIE LANE SALINAS CA 93901 MONTEREY 8317574333 050335 SONORA REGIONAL MEDICAL CENTER 1000 GREENLEY ROAD SONORA CA 95370 TUOLUMNE 2095323161 050336 LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVENUE LODI CA 95240 SAN JOAQUIN 2093343411 050342 PIONEERS MEMORIAL HEALTHCARE DISTRICT 207 WEST LEGION ROAD BRAWLEY CA 92227 IMPERIAL 7603513333
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 20 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050348 UNIVERSITY OF CALIFORNIA IRVINE MED CENTER 101 CITY DRIVE SOUTH ORANGE CA 92868 ORANGE 7144566112 05034F VA HOSP 16111 PLUMMER ST SEPULVEDA CA 91343 LOS ANGELES 9995551212 050350 BEVERLY HOSPITAL 309 W BEVERLY BLVD MONTEBELLO CA 90640 LOS ANGELES 3237261222 050351 TORRANCE MEMORIAL MEDICAL CENTER 3330 LOMITA BLVD TORRANCE CA 90509 LOS ANGELES 3103259110 050352 BARTON MEMORIAL HOSPITAL 2170 SOUTH AVENUE SOUTH LAKE TAHOE CA 96150 EL DORADO 5305413420 050353 PROVIDENCE LITTLE COMPANY OF MARY MED CTR 4101 TORRANCE BLVD TORRANCE CA 90503 LOS ANGELES 3105407676 TORRANCE 050357 GOLETA VALLEY COTTAGE HOSPITAL 351 S PATTERSON AVE SANTA BARBARA CA 93111 SANTA BARBARA 8056816446 050359 TULARE REGIONAL MEDICAL CENTER 869 CHERRY AVENUE TULARE CA 93274 TULARE 5596880821 050360 MARIN GENERAL HOSPITAL 250 BON AIR ROAD, PO BOX 8010 GREENBRAE CA 94904 MARIN 4159257900 050367 NORTHBAY MEDICAL CENTER 1200 B GALE WILSON BLVD FAIRFIELD CA 94533 SOLANO 7076465000 05036F US NAVAL HOSP BARSTOW CA 92311 SAN BERNARDINO 9995551212 050373 LAC+USC MEDICAL CENTER 1200 N STATE ST, ROOM C2K100 LOS ANGELES CA 90033 LOS ANGELES 3232262800 050376 LAC/HARBOR‐UCLA MED CENTER 1000 W CARSON ST TORRANCE CA 90502 LOS ANGELES 3102222101 050378 PACIFICA HOSPITAL OF THE VALLEY 9449 SAN FERNANDO RD SUN VALLEY CA 91352 LOS ANGELES 8187673310 05037F US NAVAL HOSP U S NAVAL ORDNANCE TEST STATION CHINA LAKE CA 93555 KERN 9995551212 050380 GOOD SAMARITAN HOSPITAL 2425 SAMARITAN DRIVE SAN JOSE CA 95124 SANTA CLARA 4085592011 050382 CITRUS VALLEY MEDICAL CENTER‐IC CAMPUS 210 W SAN BERNARDINO ROAD COVINA CA 91723 LOS ANGELES 6268142468 05038F US NAVAL HOSP U S NAVAL CONSTRUCTION BATTALION PORT HUENEME CA 93041 VENTURA 9995551212 050390 HEMET VALLEY MEDICAL CENTER 1117 EAST DEVONSHIRE HEMET CA 92543 RIVERSIDE 9516522811 050393 PIH HOSPITAL ‐ DOWNEY 11500 BROOKSHIRE AVENUE DOWNEY CA 90241 LOS ANGELES 5269045000 050394 COMMUNITY MEMORIAL HOSPITAL SAN BUENAVENTURA 147 N BRENT ST VENTURA CA 93003 VENTURA 8056525011
050396 SANTA BARBARA COTTAGE HOSPITAL 400 WEST PUEBLO SANTA BARBARA CA 93102 SANTA BARBARA 8056827111 050397 COALINGA REGIONAL MEDICAL CENTER 1191 PHELPS AVENUE COALINGA CA 93210 FRESNO 5599356400 05039F US NAVAL HOSP MARINE CORPS BASE TWENTYNINE PALMS CA 92277 SAN BERNARDINO 9995551212 050407 CHINESE HOSPITAL 845 JACKSON ST SAN FRANCISCO CA 94133 4159822400 05040F US ARMY HOSP SIERRA ARMY DEPOT HERLONG CA 96113 LASSEN 9995551212 050411 KAISER FOUNDATION HOSPITAL ‐ SOUTH BAY 25825 SOUTH VERMONT AVENUE HARBOR CITY CA 90710 LOS ANGELES 3105176441 050414 MERCY HOSPITAL OF FOLSOM 1650 CREEKSIDE DRIVE FOLSOM CA 95630 SACRAMENTO 9169837400 050417 SUTTER COAST HOSPITAL 800 E WASHINGTON BLVD CRESCENT CITY CA 95531 DEL NORTE 7074648880
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 21 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 05041F US ARMY HOSP FT IRWIN BARSTOW CA 92311 SAN BERNARDINO 9995551212 050423 PALO VERDE HOSPITAL 250 NORTH FIRST STREET BLYTHE CA 92225 RIVERSIDE 7609224115 050424 SCRIPPS GREEN HOSPITAL 10666 NORTH TORREY PINES ROAD LA JOLLA CA 92037 SAN DIEGO 8584559100 050425 KAISER FOUNDATION HOSPITAL ‐ SACRAMENTO 2025 MORSE AVENUE SACRAMENTO CA 95825 SACRAMENTO 9169735000 050426 WEST ANAHEIM MEDICAL CENTER 3033 W ORANGE AVENUE ANAHEIM CA 92804 ORANGE 7148273000 050435 FALLBROOK HOSPITAL DISTRICT 624 E ELDER ST FALLBROOK CA 92028 SAN DIEGO 7607281191 050438 HUNTINGTON MEMORIAL HOSPITAL 100 W CALIFORNIA BLVD PASADENA CA 91109 LOS ANGELES 6263975000 050441 STANFORD HEALTH CARE 300 PASTEUR DRIVE STANFORD CA 94305 SANTA CLARA 6507235708 050444 MERCY MEDICAL CENTER 333 MERCY AVENUE MERCED CA 95340 MERCED 2095645000 050454 UCSF MEDICAL CENTER 505 PARNASSUS AVE, BOX 0296 SAN FRANCISCO CA 94143 4153532733 050455 SAN JOAQUIN COMMUNITY HOSPITAL 2615 CHESTER AVENUE BAKERSFIELD CA 93301 KERN 6613953000 050457 ST MARY'S MEDICAL CENTER 450 STANYAN ST SAN FRANCISCO CA 94117 4156681000 050464 DOCTORS MEDICAL CENTER 1441 FLORIDA AVENUE MODESTO CA 95350 STANISLAUS 2095781211 050468 MEMORIAL HOSPITAL OF GARDENA 1145 W REDONDO BEACH BLVD GARDENA CA 90247 LOS ANGELES 3105324200 050471 GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BOULEVARD LOS ANGELES CA 90017 LOS ANGELES 2139772121 050481 WEST HILLS HOSPITAL & MEDICAL CENTER 7300 MEDICAL CENTER DR WEST HILLS CA 91307 LOS ANGELES 8186764100 050485 LONG BEACH MEMORIAL MEDICAL CENTER 2801 ATLANTIC AVE LONG BEACH CA 90806 LOS ANGELES 5629332000 050488 EDEN MEDICAL CENTER 20103 LAKE CHABOT ROAD CASTRO VALLEY CA 94546 ALAMEDA 5105371234 050492 CLOVIS COMMUNITY MEDICAL CENTER 2755 HERNDON AVE CLOVIS CA 93611 FRESNO 5593244000 050496 JOHN MUIR MEDICAL CENTER ‐ CONCORD CAMPUS 2540 EAST ST CONCORD CA 94520 CONTRA COSTA 9256828200 050498 SUTTER AUBURN FAITH HOSPITAL 11815 EDUCATION STREET AUBURN CA 95603 PLACER 5308884500 050502 SAINT VINCENT MEDICAL CENTER 2131 W 3RD ST LOS ANGELES CA 90057 LOS ANGELES 2134847111 050503 SCRIPPS MEMORIAL HOSPITAL ‐ ENCINITAS 354 SANTA FE DRIVE ENCINITAS CA 92024 SAN DIEGO 7607536501 050506 SIERRA VISTA REGIONAL MEDICAL CENTER 1010 MURRAY ST SAN LUIS OBISPO CA 93405 SAN LUIS OBISPO 8505467600 050510 KAISER FOUNDATION HOSPITAL 99 MONTECILLO RD SAN RAFAEL CA 94903 MARIN 4154442000 050512 KAISER FOUNDATION HOSPITAL ‐ FREMONT 39400 PASEO PADRE PKWY FREMONT CA 94538 ALAMEDA 5107844000 050515 KAISER FOUNDATION HOSPITAL ‐ SAN DIEGO 4647 ZION AVE SAN DIEGO CA 92120 SAN DIEGO 6195285000 050516 MERCY SAN JUAN MEDICAL CENTER 6501 COYLE AVE CARMICHAEL CA 95608 SACRAMENTO 9165375000 050517 VICTOR VALLEY GLOBAL MEDICAL CENTER 15248 11TH ST VICTORVILLE CA 92392 SAN BERNARDINO 7602458691 050523 SUTTER DELTA MEDICAL CENTER 3901 LONE TREE WAY ANTIOCH CA 94509 CONTRA COSTA 9257797200
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 22 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050526 HUNTINGTON BEACH HOSPITAL 17772 BEACH BLVD HUNTINGTON BEACH CA 92647 ORANGE 7148435000 050528 MEMORIAL HOSPITAL LOS BANOS 520 WEST I ST LOS BANOS CA 93635 MERCED 2098260591 050534 JOHN F KENNEDY MEMORIAL HOSPITAL 47111 MONROE STREET INDIO CA 92201 RIVERSIDE 7603476191 050537 SUTTER DAVIS HOSPITAL 2000 SUTTER PLACE DAVIS CA 95616 YOLO 5307566440 050541 KAISER FOUNDATION HOSPITAL ‐ REDWOOD CITY 1100 VETERANS BOULEVARD REDWOOD CITY CA 94063 SAN MATEO 6502992000 050543 COLLEGE HOSPITAL COSTA MESA 301 VICTORIA STREET COSTA MESA CA 92627 ORANGE 9496422734 050546 PORTERVILLE DEVELOPMENTAL CENTER 26501 AVENUE 140 PORTERVILLE CA 93257 TULARE 5597822222 050547 SONOMA DEVELOPMENTAL CENTER 15000 ARNOLD DRIVE / P O BOX 1493 ELDRIDGE CA 95431 SONOMA 7079386000 050548 FAIRVIEW DEVELOPMENTAL CENTER 2501 HARBOR BOULEVARD COSTA MESA CA 92626 ORANGE 7149575000 050549 LOS ROBLES HOSPITAL & MEDICAL CENTER 215 W JANSS RD THOUSAND OAKS CA 91360 VENTURA 8054972727 05054E UNIVERSITY OF SOUTHERN CALIFORNIA INF 849 W 34TH ST LOS ANGELES CA 90007 LOS ANGELES 9995551212 050551 LOS ALAMITOS MEDICAL CENTER 3751 KATELLA AVENUE LOS ALAMITOS CA 90720 ORANGE 5627993220 050552 MOTION PICTURE & TELEVISION HOSPITAL 23388 MULHOLLAND DRIVE WOODLAND HILLS CA 91364 LOS ANGELES 8188761888 050557 MEMORIAL MEDICAL CENTER 1700 COFFEE RD MODESTO CA 95355 STANISLAUS 2095264500 050561 KAISER FOUNDATION HOSPITAL ‐ WEST LA 6041 CADILLAC AVE LOS ANGELES CA 90034 LOS ANGELES 2138572201 050567 MISSION HOSPITAL REGIONAL MED CENTER 27700 MEDICAL CENTER RD MISSION VIEJO CA 92691 ORANGE 9493641400 050568 MADERA COMMUNITY HOSPITAL 1250 E ALMOND AVE MADERA CA 93637 MADERA 5596755555 050570 FOUNTAIN VALLEY REGIONAL HOSPITAL & MEDICAL 17100 EUCLID STREET FOUNTAIN VALLEY CA 92708 ORANGE 7149667200 CENTER 050573 EISENHOWER MEDICAL CENTER 39‐000 BOB HOPE DRIVE RANCHO MIRAGE CA 92270 RIVERSIDE 7603403911 050575 GARDENS REGIONAL HOSPITAL AND MEDICAL CENTER 21530 S PIONEER BLVD HAWAIIAN GARDENS CA 90716 LOS ANGELES 5628600401
050580 LA PALMA INTERCOMMUNITY HOSPITAL 7901 WALKER STREET LA PALMA CA 90623 ORANGE 7146707400 050581 LAKEWOOD REGIONAL MEDICAL CENTER 3700 E SOUTH ST LAKEWOOD CA 90712 LOS ANGELES 5626026751 050586 CHINO VALLEY MEDICAL CENTER 5451 WALNUT AVE CHINO CA 91710 SAN BERNARDINO 9096276111 050588 SAN DIMAS COMMUNITY HOSPITAL 1350 W COVINA BLVD SAN DIMAS CA 91773 LOS ANGELES 9095996811 050589 PLACENTIA LINDA HOSPITAL 1301 N ROSE DRIVE PLACENTIA CA 92870 ORANGE 7149932000 050590 METHODIST HOSPITAL OF SACRAMENTO 7500 HOSPITAL DRIVE SACRAMENTO CA 95823 SACRAMENTO 9164236010 050597 FOOTHILL PRESBYTERIAN HOSPITAL 250 S GRAND AVE GLENDORA CA 91740 LOS ANGELES 6269638411 050599 UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER 2315 STOCKTON BOULEVARD SACRAMENTO CA 95817 SACRAMENTO 9167342011 050603 SADDLEBACK MEMORIAL MEDICAL CENTER 24451 HEALTH CENTER DRIVE LAGUNA HILLS CA 92653 ORANGE 9498374500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 23 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050604 KAISER FOUNDATION HOSPITAL‐SAN JOSE 250 HOSPITAL PARKWAY SAN JOSE CA 95119 SANTA CLARA 4089727000 050608 DELANO REGIONAL MEDICAL CENTER 1401 GARCES HIGHWAY DELANO CA 93215 KERN 6617254800 050609 KAISER FOUNDATION HOSPITAL ‐ ORANGE COUNTY ‐ 3440 E LA PALMA AVE ANAHEIM CA 92806 ORANGE 7142794000 ANAHE 050616 ST JOHNS PLEASANT VALLEY HOSPITAL 2309 ANTONIO AVE CAMARILLO CA 93010 VENTURA 8053895800 05061E SANTA BARBARA COLLEGE INFIRMARY SANTA BARBARA CA 93105 SANTA BARBARA 9995551212 050624 HENRY MAYO NEWHALL HOSPITAL 23845 MCBEAN PKWY VALENCIA CA 91355 LOS ANGELES 6612538000 050625 CEDARS‐SINAI MEDICAL CENTER 8700 BEVERLY BLVD LOS ANGELES CA 90048 LOS ANGELES 3104235000 05062E FAIRHAVEN HOME & HOSP 4360 63RD ST SACRAMENTO CA 95820 SACRAMENTO 9161111111 050633 TWIN CITIES COMMUNITY HOSPITAL 1100 LAS TABLAS RD TEMPLETON CA 93465 SAN LUIS OBISPO 8054343500 050636 POMERADO HOSPITAL 15615 POMERADO ROAD POWAY CA 92064 SAN DIEGO 8584856511 050641 EAST LOS ANGELES DOCTORS HOSPITAL 4060 WHITTIER BLVD LOS ANGELES CA 90023 LOS ANGELES 3232685514 050660 USC KENNETH NORRIS JR CANCER HOSPITAL 1441 EASTLAKE AVE LOS ANGELES CA 90089 LOS ANGELES 3238653000 050663 LOS ANGELES COMMUNITY HOSPITAL 4081 E OLYMPIC BLVD LOS ANGELES CA 90023 LOS ANGELES 3232670477 050668 LAGUNA HONDA HOSPITAL & REHABILITATION CENTER 375 LAGUNA HONDA BLVD SAN FRANCISCO CA 94116 4157592300
05066E UNIVERSITY OF CALIF STUDENT HLTH CTR DAVIS CA 95616 YOLO 9161111111 050674 KAISER FOUNDATION HOSP SO SACRAMENTO 6600 BRUCEVILLE ROAD SACRAMENTO CA 95823 SACRAMENTO 9166882000 050677 KAISER FOUNDATION HOSPITAL ‐ WOODLAND HILLS 5601 DE SOTO WOODLAND HILLS CA 91367 LOS ANGELES 8187193800 050678 ORANGE COAST MEMORIAL MEDICAL CENTER 9920 TALBERT AVENUE FOUNTAIN VALLEY CA 92708 ORANGE 7143787406 050680 NORTHBAY VACAVALLEY HOSPITAL 1000 NUT TREE ROAD VACAVILLE CA 95688 SOLANO 7076247000 050684 MENIFEE VALLEY MEDICAL CENTER 28400 MCCALL B0ULEVARD SUN CITY CA 92585 RIVERSIDE 9516798888 050686 KAISER FOUNDATION HOSPITAL, RIVERSIDE 10800 MAGNOLIA AVENUE RIVERSIDE CA 92505 RIVERSIDE 9513532000 050688 SAINT LOUISE REGIONAL HOSPITAL 9400 NO NAME UNO GILROY CA 95020 SANTA CLARA 4088482000 050689 SAN RAMON REGIONAL MEDICAL CTR 6001 NORRIS CANYON ROAD SAN RAMON CA 94583 CONTRA COSTA 9252759200 050690 KAISER FOUNDATION HOSPITAL‐SANTA ROSA 401 BICENTENNIAL WAY SANTA ROSA CA 95403 SONOMA 7075714000 050696 KECK HOSPITAL OF USC 1500 SAN PABLO ST LOS ANGELES CA 90033 LOS ANGELES 3234428656 050697 PATIENTS' HOSPITAL OF REDDING 2900 EUREKA WAY REDDING CA 96001 SHASTA 5302258700 050701 SOUTHWEST HEALTHCARE SYSTEM 25500 MEDICAL CENTER DRIVE MURRIETA CA 92562 RIVERSIDE 9516966000 050704 MISSION COMMUNITY HOSPITAL 14850 ROSCOE BLVD PANORAMA CITY CA 91402 LOS ANGELES 8189043100 050708 FRESNO SURGICAL HOSPITAL 6125 NORTH FRESNO ST FRESNO CA 93710 FRESNO 5594318000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 24 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050709 DESERT VALLEY HOSPITAL 16850 BEAR VALLEY RD VICTORVILLE CA 92395 SAN BERNARDINO 7602418000 050710 KAISER FOUNDATION HOSPITAL ‐ FRESNO 7300 NORTH FRESNO ST FRESNO CA 93720 FRESNO 5594484500 050714 SUTTER MATERNITY & SURGERY CENTER OF SANTA CRUZ 2900 CHANTICLEER AVENUE SANTA CRUZ CA 95065 SANTA CRUZ 8314772200
050717 LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION 7601 EAST IMPERIAL HIGHWAY DOWNEY CA 90242 LOS ANGELES 5624017022 CTR 050723 KAISER FOUNDATION HOSPITAL ‐ BALDWIN PARK 1011 BALDWIN PARK BLVD BALDWIN PARK CA 91706 LOS ANGELES 6268511011 050724 BAKERSFIELD HEART HOSPITAL 3001 SILLECT AVENUE BAKERSFIELD CA 93308 KERN 6613166000 050726 STANISLAUS SURGICAL HOSPITAL 1421 OAKDALE ROAD MODESTO CA 95355 STANISLAUS 2095722700 050727 COMMUNITY HOSPITAL OF LONG BEACH 1720 TERMINO AVENUE LONG BEACH CA 90804 LOS ANGELES 5624940600 050732 FRESNO HEART AND SURGICAL HOSPITAL 15 EAST AUDUBON DRIVE FRESNO CA 93720 FRESNO 5594338000 050735 WHITTIER HOSPITAL MEDICAL CENTER 9080 COLIMA RD WHITTIER CA 90605 LOS ANGELES 5629453561 050736 MONTEREY PARK HOSPITAL 900 S ATLANTIC BLVD MONTEREY PARK CA 91754 LOS ANGELES 6265709000 050737 GARFIELD MEDICAL CENTER 525 N GARFIELD AVE MONTEREY PARK CA 91754 LOS ANGELES 6265732222 050738 GREATER EL MONTE COMMUNITY HOSPITAL 1701 SANTA ANITA AVE SOUTH EL MONTE CA 91733 LOS ANGELES 6263507975 050739 CENTINELA HOSPITAL MEDICAL CENTER 555 EAST HARDY STREET INGLEWOOD CA 90301 LOS ANGELES 3106734660 050740 MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY CA 90291 LOS ANGELES 3108238911 050742 OLYMPIA MEDICAL CENTER 5900 WEST OLYMPIC BOULEVARD LOS ANGELES CA 90036 LOS ANGELES 3106575900 050744 ANAHEIM GLOBAL MEDICAL CENTER 1025 S ANAHEIM BLVD ANAHEIM CA 92805 ORANGE 7145336220 050745 CHAPMAN GLOBAL MEDICAL CENTER 2601 E CHAPMAN AVE ORANGE CA 92869 ORANGE 7146330011 050746 ORANGE COUNTY GLOBAL MEDICAL CENTER 1001 NORTH TUSTIN AVENUE SANTA ANA CA 92705 ORANGE 7149533331 050747 SOUTH COAST GLOBAL MEDICAL CENTER 2701 S BRISTOL ST SANTA ANA CA 92704 ORANGE 7147545454 050748 KAISER FOUNDATION HOSPITAL MANTECA 1777 WEST YOSEMITE AVE MANTECA CA 95337 SAN JOAQUIN 2098253700 050751 MIRACLE MILE MEDICAL CENTER 6000 SAN VICENTE BLVD LOS ANGELES CA 90036 LOS ANGELES 3239301040 050754 MENLO PARK SURGICAL HOSPITAL 570 WILLOW ROAD MENLO PARK CA 94025 SAN MATEO 6503248500 050755 SHERMAN OAKS HOSPITAL 4929 VAN NUYS BLVD SHERMAN OAKS CA 91403 LOS ANGELES 8189817111 050757 ALVARADO HOSPITAL MEDICAL CENTER 6655 ALVARADO ROAD SAN DIEGO CA 92120 SAN DIEGO 6192293172 050758 MONTCLAIR HOSPITAL MEDICAL CENTER 5000 SAN BERNARDINO ST MONTCLAIR CA 91763 SAN BERNARDINO 9096258300 050760 KAISER FOUNDATION HOSPITAL ‐ ANTIOCH 4501 SAND CREEK ROAD ANTIOCH CA 94531 CONTRA COSTA 9258136500 050761 PROVIDENCE TARZANA MEDICAL CENTER 18321 CLARK STREET TARZANA CA 91356 LOS ANGELES 8188810800 050763 SILVER LAKE MEDICAL CENTER 1711 WEST TEMPLE STREET LOS ANGELES CA 90026 LOS ANGELES 2139896123
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 25 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 050764 SHASTA REGIONAL MEDICAL CENTER 1100 BUTTE ST REDDING CA 96001 SHASTA 5302445454 050765 KAISER FOUNDATION HOSPITAL‐MORENO VALLEY 27300 IRIS AVENUE MORENO VALLEY CA 92555 RIVERSIDE 9512516000 050766 SUTTER SURGICAL HOSPITAL ‐ NORTH VALLEY 455 PLUMAS BLVD YUBA CITY CA 95991 SUTTER 5307495700 050767 KAISER FOUNDATION HOSPITAL ‐ VACAVILLE 1 QUALITY DRIVE VACAVILLE CA 95688 SOLANO 7076244000 050769 HOAG ORTHOPEDIC INSTITUTE 16250 SAND CANYON AVENUE IRVINE CA 92618 ORANGE 9497275000 050770 LOMA LINDA UNIVERSITY MEDICAL CENTER‐MURRIETA 28062 BAXTER ROAD MURRIETA CA 92563 RIVERSIDE 9512904000
050771 COAST PLAZA HOSPITAL 13100 STUDERBAKER ROAD NORWALK CA 90650 LOS ANGELES 3103560550 050772 KAISER FOUNDATION HOSPITAL ‐ ROSEVILLE 1600 EUREKA ROAD ROSEVILLE CA 95661 PLACER 9167844000 050773 SAN LEANDRO HOSPITAL 13855 E 14TH STREET SAN LEANDRO CA 94578 ALAMEDA 5103576500 050775 TEMECULA VALLEY HOSPITAL 31700 TEMECULA PKWY TEMECULA CA 92592 RIVERSIDE 9513312200 050776 COLLEGE MEDICAL CENTER 2776 PACIFIC AVENUE LONG BEACH CA 90806 LOS ANGELES 5625951911 050777 KAISER FOUNDATION HOSPITAL ‐ SAN LEANDRO 2500 MERCED STREET SAN LEANDRO CA 94577 ALAMEDA 5104541000 050778 LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL 11234 ANDERSON STREET SUITE ALOMA LINDA CA 92354 SAN BERNARDINO 9095588000 050779 MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL 1680 EAST 120TH STREET LOS ANGELES CA 90059 LOS ANGELES 4248356808 050780 FOOTHILL REGIONAL MEDICAL CENTER 14662 NEWPORT AVE TUSTIN CA 92780 ORANGE 7146197700 050781 SONOMA WEST MEDICAL CENTER 501 PETALUMA AVENUE SEBASTOPOL CA 95472 SONOMA 7078238511 050782 CASA COLINA HOSPITAL 255 E BONITA AVE POMONA CA 91767 LOS ANGELES 9095967733 05083E SANTA MARTA HOSP & CLINIC 328 N HUMPHREY AVE LOS ANGELES CA 90022 LOS ANGELES 9995551212 05085E UNIVERSITY OF CALIFORNIA INFIRMARY RIVERSIDE CA 92503 RIVERSIDE 9092222222 05086E W C JONES MEM HOSP 328 S CHURCH ST GRASS VALLEY CA 95945 NEVADA 9995551212 05087E ERNEST COWELL MEM HOSP STRAWBERRY CREEK + COLLEGE AVE BERKELEY CA 94704 ALAMEDA 9995551212 05090E SHRINERS HOSP FOR CRIPPLED CHILDREN 1701 19TH AVE SAN FRANCISCO CA 94122 4151111111 05098E LAS ENCINAS HOSP 2900 E DEL MAR BLVD PASADENA CA 91107 LOS ANGELES 6267959901 05099E GILMORE HOSP 384 W ESTUDILLO AVE SAN LEANDRO CA 94577 ALAMEDA 9995551212 05101E LOS BANOS EMERGENCY HOSP 925 PACHECO HWY LOS BANOS CA 93635 MERCED 9995551212 05106E DANIS PSYCHIATRIC HOSP 45 E ALAMAR AVE SANTA BARBARA CA 93105 SANTA BARBARA 9995551212 05113F U S NAVAL HOSP 7500 E CARSON ST LONG BEACH CA 90801 LOS ANGELES 9995551212 05114F VETERANS ADMINISTRATION HOSP 3350 LA JOLLA VILLAGE DR SAN DIEGO CA 92161 SAN DIEGO 8585528585 05115E SOUTHWOOD MENTAL HEALTH CENTER 950 3RD AVE CARLSBAD CA 92011 SAN DIEGO 9995551212
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 26 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 05127E JERRY PETTIS MEM VETERANS HOSP 11201 BENTON ST LOMA LINDA CA 92357 SAN BERNARDINO 9995551212 05128F VETERANS AFFAIRS MEDICAL CENTER 11301 WILSHIRE BOULEVARD LOS ANGELES CA 90073 LOS ANGELES 3104783711 05129F ROBERT E BUSH NAVAL HOSPITAL PO BOX 788250 MCAGCC, BUILDING 1145 STURGIS STREET TWENTYNINE PALMS CA 92278 SAN BERNARDINO 7608302498
051300 EASTERN PLUMAS HOSPITAL ‐ PORTOLA CAMPUS 500 FIRST AVENUE PORTOLA CA 96122 PLUMAS 5308324277 051301 ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI VALLEY 115 WEST E STREET TEHACHAPI CA 93561 KERN 6618223241
051302 SOUTHERN INYO HOSPITAL 501 EAST LOCUST STREET LONE PINE CA 93545 INYO 7608765501 051303 MAMMOTH HOSPITAL 85 SIERRA PARK ROAD PO BOX 660 MAMMOTH LAKES CA 93546 MONO 7609343311 051304 JOHN C FREMONT HEALTHCARE DISTRICT 5189 HOSPITAL ROAD MARIPOSA CA 95338 MARIPOSA 2099663631 051305 MAYERS MEMORIAL HOSPITAL 43563 HWY 299 EAST FALL RIVER MILLS CA 96028 SHASTA 5303365511 051306 GLENN MEDICAL CENTER 1133 W SYCAMORE ST WILLOWS CA 95988 GLENN 5309341818 051307 CATALINA ISLAND MEDICAL CENTER 100 FALLS CANYON ROAD AVALON CA 90704 LOS ANGELES 3105100700 051308 SURPRISE VALLEY COMMUNITY HOSPITAL 741 NORTH MAIN STREET CEDARVILLE CA 96104 MODOC 5302796111 051309 JEROLD PHELPS COMMUNITY HOSPITAL 733 CEDAR ST GARBERVILLE CA 95542 HUMBOLDT 7079233921 05130F SAN FRANCISCO VA MEDICAL CENTER 4150 CLEMENT STREET SAN FRANCISCO CA 94121 2022664557 051310 FRANK R HOWARD MEMORIAL HOSPITAL 1 MARCELA DR WILLITS CA 95490 MENDOCINO 7074563031 051311 ORCHARD HOSPITAL 240 SPRUCE STREET GRIDLEY CA 95948 BUTTE 5308465671 051312 MOUNTAINS COMMUNITY HOSPITAL 29101 HOSPITAL ROAD LAKE ARROWHEAD CA 92352 SAN BERNARDINO 9093363651 051314 KERN VALLEY HEALTHCARE DISTRICT 6412 LAUREL AVE LAKE ISABELLA CA 93240 KERN 7603792681 051315 TRINITY HOSPITAL 60 EASTER AVENUE WEAVERVILLE CA 96093 TRINITY 5306235541 051316 FAIRCHILD MEDICAL CENTER 444 BRUCE STREET YREKA CA 96097 SISKIYOU 5308424121 051317 ST HELENA HOSPITAL‐CLEARLAKE 15630 18TH AVE ‐ HWY 53 CLEARLAKE CA 95422 LAKE 7079946486 051318 REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA CA 95540 HUMBOLDT 7074458121 051319 MERCY MEDICAL CENTER MT SHASTA 914 PINE STREET MOUNT SHASTA CA 96067 SISKIYOU 5309266111 051320 BANNER LASSEN MEDICAL CENTER 1800 SPRING RIDGE DRIVE SUSANVILLE CA 96130 LASSEN 5302522000 051321 HEALDSBURG DISTRICT HOSPITAL 1375 UNIVERSITY AVENUE HEALDSBURG CA 95448 SONOMA 7074316500 051323 COLORADO RIVER MEDICAL CENTER 1401 BAILEY AVE NEEDLES CA 92363 SAN BERNARDINO 7603264531 051324 NORTHERN INYO HOSPITAL 150 PIONEER LANE BISHOP CA 93514 INYO 7608735811 051325 MENDOCINO COAST DISTRICT HOSPITAL 700 RIVER DR FORT BRAGG CA 95437 MENDOCINO 7079611234 051326 PLUMAS DISTRICT HOSPITAL 1065 BUCKS LAKE ROAD QUINCY CA 95971 PLUMAS 5302832121
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 27 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 051327 SENECA DISTRICT HOSPITAL 130 BRENTWOOD DRIVE CHESTER CA 96020 PLUMAS 5302582121 051328 TAHOE FOREST HOSPITAL 10121 PINE AVE TRUCKEE CA 96161 NEVADA 5305876011 051329 SUTTER LAKESIDE HOSPITAL 5176 HILL ROAD EAST LAKEPORT CA 95453 LAKE 7072625000 051330 MODOC MEDICAL CENTER 228 W MCDOWELL AVE ALTURAS CA 96101 MODOC 5302335131 051331 SANTA YNEZ VALLEY COTTAGE HOSPITAL 2050 VIBORG RD SOLVANG CA 93463 SANTA BARBARA 8056886431 051332 MARK TWAIN MEDICAL CENTER 768 MOUNTAIN RANCH RD SAN ANDREAS CA 95249 CALAVERAS 2097542515 051333 RIDGECREST REGIONAL HOSPITAL 1081 NORTH CHINA LAKE BLVD RIDGECREST CA 93555 KERN 7604463551 051334 OJAI VALLEY COMMUNITY HOSPITAL 1306 MARICOPA HWY OJAI CA 93023 VENTURA 8056402280 051335 BEAR VALLEY COMMUNITY HOSPITAL 41870 GARSTIN DR BIG BEAR LAKE CA 92315 SAN BERNARDINO 9098666501 051990 SUNLAND HOME CORPORATION 691 SPARTA DRIVE ENCINITAS CA 92024 SAN DIEGO 7609442976 051991 BROADVIEW INC 4570 GRIFFIN AVENUE LOS ANGELES CA 90031 LOS ANGELES 2132219174 051993 ARDEN WOOD, INC 445 WAWONA STREET SAN FRANCISCO CA 94116 4156815500 051994 FERN LODGE, INC 18457 MADISON AVENUE CASTRO VALLEY CA 94546 ALAMEDA 5108862448 051995 OLIVE GLEN FOUNDATION 3025 BECERRA WAY SACRAMENTO CA 95821 SACRAMENTO 9164861161 052031 BARLOW RESPIRATORY HOSPITAL 2000 STADIUM WAY LOS ANGELES CA 90026 LOS ANGELES 2132504200 052032 KINDRED ‐ LOS ANGELES 5525 W SLAUSON AVENUE LOS ANGELES CA 90056 LOS ANGELES 3106420325 052033 VIBRA HOSPITAL OF SACRAMENTO 330 MONTROSE DRIVE FOLSOM CA 95630 SACRAMENTO 9163519151 052034 KINDRED HOSPITAL ‐ SAN FRANCISCO BAY AREA 2800 BENEDICT DRIVE SAN LEANDRO CA 94577 ALAMEDA 5103578300 052035 KINDRED HOSPITAL WESTMINSTER 200 HOSPITAL CIRCLE WESTMINSTER CA 92683 ORANGE 7148934541 052036 KINDRED HOSPITAL ‐ SAN DIEGO 1940 EL CAJON BLVD SAN DIEGO CA 92104 SAN DIEGO 6195434500 052037 KINDRED HOSPITAL ONTARIO 550 NORTH MONTEREY ONTARIO CA 91764 SAN BERNARDINO 9093910333 052038 KINDRED HOSPITAL ‐‐ LA MIRADA 14900 E IMPERIAL HWY LA MIRADA CA 90638 LOS ANGELES 5629441900 052039 KINDRED HOSPITAL BREA 875 N BREA BLVD BREA CA 92821 ORANGE 7145296842 052043 KENTFIELD REHABILITATION & SPECIALTY HOSPITAL 1125 SIR FRANCIS DRAKE BLVD KENTFIELD CA 94904 MARIN 4154569680 052044 VIBRA HOSPITAL OF SAN DIEGO 555 WASHINGTON STREET SAN DIEGO CA 92103 SAN DIEGO 6192608300 052045 KINDRED HOSPITAL BALDWIN PARK 14148 EAST FRANCISQUITO AVENUE BALDWIN PARK CA 91706 LOS ANGELES 6263882700 052046 PROMISE HOSPITAL OF EAST LOS ANGELES 443 SOUTH SOTO STREET LOS ANGELES CA 90033 LOS ANGELES 3232611181 052047 VIBRA HOSPITAL OF NORTHERN CALIFORNIA 2801 EUREKA WAY REDDING CA 96001 SHASTA 5302469000 052049 KINDRED HOSPITAL RANCHO 10841 WHITE OAK AVENUE RANCHO CUCAMONGA CA 91730 SAN BERNARDINO 9095816400 052050 KINDRED HOSPITAL SOUTH BAY 1246 WEST 155TH STREET GARDENA CA 90247 LOS ANGELES 3103235330
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 28 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 052051 PROMISE HOSPITAL OF SAN DIEGO 5550 UNIVERSITY AVENUE SAN DIEGO CA 92105 SAN DIEGO 6195823800 052052 KINDRED HOSPITAL RIVERSIDE 2224 MEDICAL CENTER DRIVE PERRIS CA 92571 RIVERSIDE 9514363535 052054 MONROVIA MEMORIAL HOSPITAL 323 SOUTH HELIOTROPE AVENUE MONROVIA CA 91016 LOS ANGELES 6263599341 053031 HEALTHSOUTH BAKERSFIELD REHABILITATION HOSPITAL 5001 COMMERCE DRIVE BAKERSFIELD CA 93309 KERN 6613235500
053032 SAN JOAQUIN VALLEY REHABILITATION HOSP 7173 N SHARON AVENUE FRESNO CA 93720 FRESNO 5594363600 053034 HEALTHSOUTH TUSTIN REHABILITATION HOSPITAL 14851 YORBA STREET TUSTIN CA 92780 ORANGE 7148329200 053037 BALLARD REHABILITATION HOSPITAL 1760 WEST 16TH ST SAN BERNARDINO CA 92411 SAN BERNARDINO 9094731275 053038 TOTALLY KIDS REHABILITATION HOSPITAL 1720 MOUNTAIN VIEW AVENUE LOMA LINDA CA 92354 SAN BERNARDINO 9097966915 053300 VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 FRESNO 5593535116 053301 CHILDREN'S HOSPITAL & RESEARCH CENTER OAKLAND 747 52ND STREET OAKLAND CA 94609 ALAMEDA 5104283000
053302 CHILDREN'S HOSP OF LOS ANGELES 4650 SUNSET BLVD LOS ANGELES CA 90027 LOS ANGELES 3236692164 053303 RADY CHILDREN'S HOSPITAL ‐ SAN DIEGO 3020 CHILDRENS WAY SAN DIEGO CA 92123 SAN DIEGO 8585761700 053304 CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 W LA VETA AVE ORANGE CA 92868 ORANGE 7149973000 053305 LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD 725 WELCH ROAD PALO ALTO CA 94304 SANTA CLARA 6504978000
053306 CHILDREN'S HOSPITAL AT MISSION 27700 MEDICAL CENTER RD, 5TH FLOOR MISSION VIEJO CA 92691 ORANGE 9493652408 053308 HEALTHBRIDGE CHILDREN'S HOSPITAL ‐ ORANGE 393 S TUSTIN STREET ORANGE CA 92866 ORANGE 7142892400 053309 MILLER CHILDREN'S HOSPITAL 2801 ATLANTIC AVENUE LONG BEACH CA 90806 LOS ANGELES 5629338001 053310 SHRINERS HOSPITALS FOR CHILDREN 3160 GENEVA STREET LOS ANGELES CA 90020 LOS ANGELES 2133883151 053311 SHRINERS HOSPITALS FOR CHILDREN NORTHERN CALIF 2425 STOCKTON BOULEVARD SACRAMENTO CA 95817 SACRAMENTO 9164532000
054009 RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA 150 MEDICAL PLAZA LOS ANGELES CA 90095 LOS ANGELES 3108256962 054028 GATEWAYS HOSP MENTAL HEALTH CTR 1891 EFFIE ST LOS ANGELES CA 90026 LOS ANGELES 2136660171 054032 BHC ALHAMBRA HOSP 4619 N ROSEMEAD BLVD ROSEMEAD CA 91770 LOS ANGELES 6262861191 054053 DEL AMO HOSPITAL 23700 CAMINO DEL SOL TORRANCE CA 90505 LOS ANGELES 3105301151 054055 COLLEGE HOSPITAL 10802 COLLEGE PL CERRITOS CA 90703 LOS ANGELES 5625951911 054069 AURORA CHARTER OAK 1161 E COVINA BLVD COVINA CA 91724 LOS ANGELES 6269661632 054074 ST. HELENA HOSPITAL CENTER FOR BEHAVIORAL HEALTH 525 OREGON ST VALLEJO CA 94590 SOLANO 7076482200
054075 ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH 7050 PARKWAY DRIVE LA MESA CA 91942 SAN DIEGO 6194654411 SYSTE
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 29 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 054077 AURORA VISTA DEL MAR HOSPITAL 801 SENECA ST VENTURA CA 93001 VENTURA 8056536434 054078 AURORA LAS ENCINAS HOSPITAL 2900 E DEL MAR BLVD PASADENA CA 91107 LOS ANGELES 8662793709 054083 KEDREN COMMUNITY MENTAL HEALTH CENTER 4211 SOUTH AVALON BLVD LOS ANGELES CA 90011 LOS ANGELES 3232330425 054087 SIERRA VISTA HOSPITAL, INC 8001 BRUCEVILLE ROAD SACRAMENTO CA 95823 SACRAMENTO 9164232000 054089 JEWISH HOME 302 SILVER AVE SAN FRANCISCO CA 94112 4153342500 054093 LOMA LINDA BEHAVIORAL MED CTR 1710 BARTON ROAD REDLANDS CA 92373 SAN BERNARDINO 9095589200 054095 AURORA SAN DIEGO 11878 AVENUE OF INDUSTRY SAN DIEGO CA 92128 SAN DIEGO 8584873200 054096 SUTTER CENTER FOR PSYCHIATRY 7700 FOLSOM BLVD SACRAMENTO CA 95826 SACRAMENTO 9163863000 054104 HERITAGE OAKS HOSPITAL 4250 AUBURN BLVD SACRAMENTO CA 95841 SACRAMENTO 9164893336 054110 FREMONT HOSPITAL 39001 SUNDALE DRIVE FREMONT CA 94538 ALAMEDA 5107961100 054111 CANYON RIDGE HOSPITAL 5353 G STREET CHINO CA 91710 SAN BERNARDINO 9095903700 054114 SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL 3851 ROSECRANS ST SAN DIEGO CA 92110 SAN DIEGO 6196928211 054122 DEPT OF STATE HOSPITALS ‐ NAPA 2100 NAPA‐VALLEJO HIGHWAY NAPA CA 94558 NAPA 7072535000 054123 ST JOSEPH'S BEHAVIORAL HEALTH CENTER 2510 N CALIFORNIA ST STOCKTON CA 95204 SAN JOAQUIN 2094612000 054124 SEMPERVIRENS 720 WOOD ST EUREKA CA 95501 HUMBOLDT 7072682990 054125 SANTA BARBARA COUNTY PSYCHIATRIC HEALTH FACILITY 315 CAMINO DEL REMEDIO SANTA BARBARA CA 93110 SANTA BARBARA 8056815244
054130 PACIFIC GROVE HOSPITAL 5900 BROCKTON AVE RIVERSIDE CA 92506 RIVERSIDE 9512758400 054131 JOHN MUIR BEHAVIORAL HEALTH CENTER 2740 GRANT STREET CONCORD CA 94524 CONTRA COSTA 9256744101 054133 DEPT OF STATE HOSPITALS ‐ METROPOLITAN ‐ PSY 11401 S NORWALK BLVD NORWALK CA 90650 LOS ANGELES 5628637011 054135 NEWPORT BAY HOSPITAL 1501 E 16TH ST NEWPORT BEACH CA 92663 ORANGE 9496509750 054144 LANGLEY PORTER PSYCHIATRIC INSTITUTE 401 PARNASSUS AVENUE SAN FRANCISCO CA 94143 4154767000 054145 SHARP MESA VISTA HOSPITAL 7850 VISTA HILL AVENUE SAN DIEGO CA 92123 SAN DIEGO 8582784110 054146 TELECARE HERITAGE PSYCHIATRIC HEALTH FACILITY 2633 E 27TH STREET, BUILDING B OAKLAND CA 94601 ALAMEDA 5105355115 054147 JOYCE EISENBERG KEEFER MEDICAL CENTER 7150 TAMPA AVENUE RESEDA CA 91335 LOS ANGELES 8187743314 054148 TARZANA TREATMENT CENTER 18646 OXNARD STREET TARZANA CA 91356 LOS ANGELES 8189961051 054149 WILLOW ROCK CENTER 2050 FAIRMONT DRIVE SAN LEANDRO CA 94578 ALAMEDA 5108955502 054150 KAISER PERMANENTE PSYCHIATRIC HEALTH FACILITY‐SANT 3840 HOMESTEAD ROAD SANTA CLARA CA 95051 SANTA CLARA 4088514850
054151 AURORA BEHAVIORAL HEALTHCARE‐SANTA ROSA, LLC 1287 FULTON ROAD SANTA ROSA CA 95401 SONOMA 7078007700
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 30 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 054152 SANTA CRUZ COUNTY PSYCHIATRIC HEALTH FACILITY 2250 SOQUEL AVENUE, SUITE 150 SANTA CRUZ CA 95062 SANTA CRUZ 8316002801 054153 OCEAN VIEW PSYCHIATRIC HEALTH FACILITY 2600 REDONDO AVENUE, SUITE 500 LONG BEACH CA 90806 LOS ANGELES 7146140474 059800 SHARP MEMORIAL HOSPITAL‐TRANSPLANT 7901 FROST STREET SAN DIEGO CA 92123 SAN DIEGO 8589393400 059801 CEDARS‐SINAI MEDICAL CENTER ‐ TRANSPLANT SERVICES 8700 BEVERLY BOULEVARD LOS ANGELES CA 90048 LOS ANGELES 3104233277
059802 WESTERN MEDICAL TRANSPLANT CENTER 1001 NORTH TUSTIN AVENUE SANTA ANA CA 92705 ORANGE 7148353555 059803 STANFORD HOSPITAL TRANSPLANT 300 PASTEUR DRIVE STANFORD CA 94305 SANTA CLARA 6507235708 059804 LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANF 725 WELCH ROAD PALO ALTO CA 94304 SANTA CLARA 6504978705
059805 RADY CHILDREN'S HOSPITAL SAN DIEGO 3020 CHILDREN'S WAY, MAIL CODE 5115 SAN DIEGO CA 92123 SAN DIEGO 8585761700 059806 CALIFORNIA PACIFIC MEDICAL CENTER 2333 BUCHANAN STREET SAN FRANCISCO CA 94115 4156001522 059807 UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 505 PARNASSUS AVENUE SAN FRANCISCO CA 94143 4153539162 059808 UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER 2315 STOCKTON BLVD, RM 1018 SACRAMENTO CA 95817 SACRAMENTO 9167345693 059809 SUTTER MEDICAL CENTER, SACRAMENTO 2825 CAPITOL AVENUE SACRAMENTO CA 95816 SACRAMENTO 9167338133 059810 UNIVERSITY OF CALIFORNIA, SAN DIEGO MEDICAL CENTER 200 WEST ARBOR DRIVE #8745 SAN DIEGO CA 92103 SAN DIEGO 6195748612
059811 UNIVERSITY OF CALIFORNIA, IRVINE MEDICAL CENTER 101 THE CITY DRIVE ORANGE CA 92868 ORANGE 7144565841
059812 RONALD REAGAN UCLA MEDICAL CENTER ‐ TRANSPLANT 757 WESTWOOD PLAZA LOS ANGELES CA 90095 LOS ANGELES 3108255041 SVS 059813 CHILDREN'S HOSPITAL OF LOS ANGELES 4650 SUNSET BLVD, MS#72 LOS ANGELES CA 90027 LOS ANGELES 3233615954 059814 LOMA LINDA UNIVERSITY MEDICAL CENTER, TRANSPLANT I 11234 ANDERSON STREET LOMA LINDA CA 92354 SAN BERNARDINO 9095588068
059815 GREEN HOSPITAL OF SCRIPPS CLINIC 10666 NORTH TORREY PINES ROAD LA JOLLA CA 92037 SAN DIEGO 8585544310 059816 ST JOSEPH HOSPITAL 1100 STEWART DRIVE ORANGE CA 92868 ORANGE 7147718087 059817 RIVERSIDE COMMUNITY HOSPITAL 4445 MAGNOLIA AVENUE RIVERSIDE CA 92501 RIVERSIDE 9516841415 059818 LAC HARBOR‐UCLA MEDICAL CENTER 1000 W CARSON STREET TORRANCE CA 90509 LOS ANGELES 3102222155 059819 KECK HOSPITAL OF USC 1500 SAN PABLO STREET LOS ANGELES CA 90033 LOS ANGELES 3234425901 059820 SAINT VINCENT MEDICAL CENTER ‐ TRANSPLANT CENTER 2131 W THIRD STREET LOS ANGELES CA 90057 LOS ANGELES 2132075681
060001 NORTH COLORADO MEDICAL CENTER 1801 16TH STREET GREELEY CO 80631 WELD 9708104121 060003 LONGMONT UNITED HOSPITAL 1950 MOUNTAIN VIEW AVENUE LONGMONT CO 80501 BOULDER 3036515111 060004 PLATTE VALLEY MEDICAL CENTER 1600 PRAIRIE CENTER PARKWAY BRIGHTON CO 80601 ADAMS 3034981601
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 31 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 060006 MONTROSE MEMORIAL HOSPITAL 800 S 3RD ST MONTROSE CO 81401 MONTROSE 9702492211 060008 SAN LUIS VALLEY HEALTH 106 BLANCA AVE ALAMOSA CO 81101 ALAMOSA 7195892511 060009 LUTHERAN MEDICAL CENTER 8300 W 38TH AVE WHEAT RIDGE CO 80033 JEFFERSON 3034254500 060010 POUDRE VALLEY HOSPITAL 1024 S LEMAY AVE FORT COLLINS CO 80524 LARIMER 9704957000 060011 DENVER HEALTH MEDICAL CENTER 777 BANNOCK ST DENVER CO 80204 3036024930 060012 CENTURA HEALTH‐ST MARY CORWIN MEDICAL CENTER 1008 MINNEQUA AVE PUEBLO CO 81004 PUEBLO 7195574000
060013 MERCY REGIONAL MEDICAL CENTER 1010 THREE SPRINGS BLVD DURANGO CO 81301 LA PLATA 9702474311 060014 PRESBYTERIAN ST LUKES MEDICAL CENTER 1719 E 19TH AVE DENVER CO 80218 3038396000 060015 CENTURA HEALTH‐ST ANTHONY HOSPITAL 11600 WEST 2ND PLACE LAKEWOOD CO 80228 JEFFERSON 7203210000 060016 CENTURA HEALTH‐ST THOMAS MORE HOSPITAL 1338 PHAY AVE CANON CITY CO 81212 FREMONT 7192852000 060020 PARKVIEW MEDICAL CENTER INC 400 W 16TH STREET PUEBLO CO 81003 PUEBLO 7195844000 060022 UNIVERSITY COLO HEALTH MEMORIAL HOSPITAL CENTRAL 1400 E BOULDER ST COLORADO SPRINGS CO 80909 EL PASO 7193655000
060023 ST MARYS MEDICAL CENTER 2635 N 7TH STREET GRAND JUNCTION CO 81502 MESA 9702981950 060024 UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 12605 EAST 16TH AVENUE AURORA CO 80045 ADAMS 7208480000 060027 FOOTHILLS HOSPITAL 4747 ARAPAHOE AVENUE BOULDER CO 80304 BOULDER 3034402273 060028 SAINT JOSEPH HOSPITAL 1375 EAST 19TH AVE DENVER CO 80218 3038122000 06002F U S AIR FORCE ACADEMY HOSPITAL US AIR FORCE ACADEMY COLORADO SPRINGS CO 80912 EL PASO 8324768316 060030 MCKEE MEDICAL CENTER 2000 BOISE AVE LOVELAND CO 80538 LARIMER 9706694640 060031 CENTURA HEALTH‐PENROSE ST FRANCIS HEALTH SERVICES 2222 N NEVADA AVE COLORADO SPRINGS CO 80907 EL PASO 7197765000
060032 ROSE MEDICAL CENTER 4567 E 9TH AVENUE DENVER CO 80220 3033202121 060034 SWEDISH MEDICAL CENTER 501 E HAMPDEN AVENUE ENGLEWOOD CO 80113 ARAPAHOE 3037885000 060036 ARKANSAS VALLEY REGIONAL MEDICAL CENTER 1100 CARSON AVENUE LA JUNTA CO 81050 OTERO 7193836000 06003F U S ARMY HOSPITAL FORT CARSON ARMY BASE FORT CARSON CO 80913 EL PASO 7190000000 060043 KEEFE MEMORIAL HOSPITAL 602 N 6TH W ST CHEYENNE WELLS CO 80810 CHEYENNE 7197675661 060044 COLORADO PLAINS MEDICAL CENTER 1000 LINCOLN ST FORT MORGAN CO 80701 MORGAN 9708673391 060049 YAMPA VALLEY MEDICAL CENTER 1024 CENTRAL PARK DR STEAMBOAT SPRINGS CO 80487 ROUTT 9708791322 060054 COMMUNITY HOSPITAL 2351 G RD GRAND JUNCTION CO 81505 MESA 9702566201 06005F V A HOSPITAL 1055 CLERMONT ST DENVER CO 80220 3030000000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 32 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 060064 CENTURA HEALTH‐PORTER ADVENTIST HOSPITAL 2525 S DOWNING ST DENVER CO 80210 3037781955 060065 NORTH SUBURBAN MEDICAL CENTER 9191 GRANT ST THORNTON CO 80229 ADAMS 3034517800 06006F V A HOSPITAL * FORT LYON CO 81038 BENT 9700000000 060071 DELTA COUNTY MEMORIAL HOSPITAL 1501 E 3RD STREET DELTA CO 81416 DELTA 9708747681 060075 VALLEY VIEW HOSPITAL ASSOCIATION 1906 BLAKE AVE GLENWOOD SPRINGS CO 81601 GARFIELD 9709456535 060076 STERLING REGIONAL MEDCENTER 615 FAIRHURST ST STERLING CO 80751 LOGAN 9705220122 06007F V A HOSPITAL 2121 NORTH AVE GRAND JUNCTION CO 81501 MESA 9700000000 060096 VAIL VALLEY MEDICAL CENTER 181 W MEADOW DRIVE VAIL CO 81657 EAGLE 9704762451 06009E HILL TOP HOSPITAL POST OFFICE BOX 397 CRIPPLE CREEK CO 80813 TELLER 7190000000 060100 MEDICAL CENTER OF AURORA, THE 1501 S POTOMAC ST AURORA CO 80012 ARAPAHOE 3036952600 060103 CENTURA HEALTH‐AVISTA ADVENTIST HOSPITAL 100 HEALTH PARK DRIVE LOUISVILLE CO 80027 BOULDER 3036731000 060104 ST ANTHONY NORTH HEALTH CAMPUS 14300 ORCHARD PARKWAY WESTMINSTER CO 80023 3034303201 060107 NATIONAL JEWISH HEALTH 1400 JACKSON ST DENVER CO 80206 3033884461 060112 SKY RIDGE MEDICAL CENTER 10101 RIDGE GATE PARKWAY LONE TREE CO 80124 DOUGLAS 7202251000 060113 CENTURA HEALTH‐LITTLETON ADVENTIST HOSPITAL 7700 S BROADWAY LITTLETON CO 80122 ARAPAHOE 3037305888 060114 PARKER ADVENTIST HOSPITAL 9395 CROWN CREST BLVD PARKER CO 80138 DOUGLAS 3032694000 060115 COLORADO MENTAL HEALTH INSTITUTE AT PUEBLO 1600 W 24TH ST PUEBLO CO 81003 PUEBLO 7195464147 060116 GOOD SAMARITAN MEDICAL CENTER 200 EXEMPLA CIRCLE LAFAYETTE CO 80026 BOULDER 3036894000 060117 ANIMAS SURGICAL HOSPITAL, LLC 575 RIVERGATE LANE DURANGO CO 81301 LA PLATA 9702473537 060118 ST ANTHONY SUMMIT MEDICAL CENTER 340 PEAK ONE DRIVE FRISCO CO 80443 SUMMIT 9706683300 060119 MEDICAL CENTER OF THE ROCKIES 2500 ROCKY MOUNTAIN AVENUE LOVELAND CO 80538 LARIMER 9706242500 06011E CLIMAX MOLYBDENUM COMPANY HOSPITAL SCHOTT BLVD CLIMAX CO 80429 LAKE 3030000000 060124 ORTHOCOLORADO HOSPITAL AT ST ANTHONY MED 11650 W 2ND PLACE LAKEWOOD CO 80228 JEFFERSON 7203215000 CAMPUS 060125 CASTLE ROCK ADVENTIST HOSPITAL 2350 MEADOWS BLVD CASTLE ROCK CO 80109 DOUGLAS 7204552500 060126 BANNER FORT COLLINS MEDICAL CENTER 4700 LADY MOON DR FORT COLLINS CO 80528 LARIMER 9702294000 06015E EMORY JOHN BRADY HOSPITAL 401 SOUTHGATE RD COLORADO SPRINGS CO 80901 EL PASO 7190000000 06019E CHILDRENS HOSPITAL ASSOCIATION THE 13123 EAST 16TH AVENUE AURORA CO 80045 ADAMS 7207771234 06020E VAIL CLINIC POST OFFICE BOX 36 VAIL CO 81657 EAGLE 9700000000 061300 WEISBROD MEMORIAL COUNTY HOSPITAL 1208 LUTHER STREET EADS CO 81036 KIOWA 7194385401
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 33 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 061301 RIO GRANDE HOSPITAL 310 COUNTY RD 14 DEL NORTE CO 81132 RIO GRANDE 7196572510 061302 COLORADO CANYONS HOSPITAL AND MEDICAL CENTER 300 WEST OTTLEY AVENUE FRUITA CO 81521 MESA 9708589871
061303 EAST MORGAN COUNTY HOSPITAL 2400 W EDISON ST BRUSH CO 80723 MORGAN 9708426200 061304 HAXTUN HOSPITAL DISTRICT 235 W FLETCHER STREET HAXTUN CO 80731 PHILLIPS 9707746123 061305 MELISSA MEMORIAL HOSPITAL 1001 E JOHNSON STREET HOLYOKE CO 80734 PHILLIPS 9708542241 061306 LINCOLN COMMUNITY HOSPITAL 111 6TH ST HUGO CO 80821 LINCOLN 7197432421 061307 RANGELY DISTRICT HOSPITAL 225 EAGLECREST RANGELY CO 81648 RIO BLANCO 9706755011 061308 SAN LUIS VALLEY HEALTH CONEJOS COUNTY HOSPITAL 19021 US HWY 285 LA JARA CO 81140 CONEJOS 7192745121
061309 WRAY COMMUNITY DISTRICT HOSPITAL 1017 W 7TH ST WRAY CO 80758 YUMA 9703324811 061310 SEDGWICK COUNTY MEMORIAL HOSPITAL 900 CEDAR STREET JULESBURG CO 80737 SEDGWICK 9704743323 061311 SOUTHEAST COLORADO HOSPITAL 373 E TENTH AVE SPRINGFIELD CO 81073 BACA 7195234501 061312 ESTES PARK MEDICAL CENTER 555 PROSPECT AVENUE ESTES PARK CO 80517 LARIMER 9705864439 061313 KIT CARSON COUNTY MEMORIAL HOSPITAL 286 16TH STREET BURLINGTON CO 80807 KIT CARSON 7193465311 061314 MEMORIAL HOSPITAL, THE 750 HOSPITAL LOOP CRAIG CO 81625 MOFFAT 9708249411 061315 YUMA DISTRICT HOSPITAL 1000 WEST 8TH AVENUE YUMA CO 80759 YUMA 9708485405 061316 SPANISH PEAKS REGIONAL HEALTH CENTER 23500 US HWY 160 WALSENBURG CO 81089 HUERFANO 7197385100 061317 GRAND RIVER MEDICAL CENTER 501 AIRPORT ROAD RIFLE CO 81650 GARFIELD 9706251510 061318 MIDDLE PARK MEDICAL CENTER 214 S 4TH STREET KREMMLING CO 80459 GRAND 9707243442 061319 ST VINCENT HOSPITAL GENERAL DISTRICT 822 W 4TH STREET LEADVILLE CO 80461 LAKE 7194860230 061320 GUNNISON VALLEY HOSPITAL 711 N TAYLOR STREET GUNNISON CO 81230 GUNNISON 9706411456 061321 MT SAN RAFAEL HOSPITAL 410 BENEDICTA AVENUE TRINIDAD CO 81082 LAS ANIMAS 7198469213 061322 HEART OF THE ROCKIES REGIONAL MEDICAL CENTER 1000 RUSH DRIVE SALIDA CO 81201 CHAFFEE 7195302200 061323 PROWERS MEDICAL CENTER 401 KENDALL DRIVE LAMAR CO 81052 PROWERS 7193364343 061324 ASPEN VALLEY HOSPITAL 0401 CASTLE CREEK ROAD ASPEN CO 81611 PITKIN 9705441261 061325 PIONEERS MEDICAL CENTER 100 PIONEERS MEDICAL CENTER DRIVE MEEKER CO 81641 RIO BLANCO 9708785047 061326 PIKES PEAK REGIONAL HOSPITAL 16420 HIGHWAY 24 WOODLAND PARK CO 80863 TELLER 7196879999 061327 SOUTHWEST MEMORIAL HOSPITAL 1311 N MILDRED RD CORTEZ CO 81321 MONTEZUMA 9705656666 061328 PAGOSA SPRINGS MEDICAL CENTER 95 SOUTH PAGOSA BOULEVARD PAGOSA SPRINGS CO 81147 ARCHULETA 9707313700 061990 WIDE HORIZON 8900 WEST 38TH AVENUE WHEAT RIDGE CO 80033 JEFFERSON 3034244445
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 34 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 062009 KINDRED HOSPITAL‐DENVER 1920 HIGH ST DENVER CO 80218 3033315219 062011 CRAIG HOSPITAL 3425 S CLARKSON ST ENGLEWOOD CO 80113 ARAPAHOE 3037898000 062012 COLORADO ACUTE LONG TERM HOSPITAL 1690 N MEADE ST DENVER CO 80204 3032646865 062013 KINDRED HOSPITAL AURORA 700 POTOMAC ST 2ND FLOOR AURORA CO 80011 ADAMS 7208578333 062014 VIBRA HOSPITAL OF DENVER 8451 PEARL ST THORNTON CO 80229 ADAMS 3032883000 062015 KINDRED HOSPITAL ‐ DENVER SOUTH 2525 S DOWNING ST 3RD FLOOR DENVER CO 80218 3038980369 062016 KINDRED HOSPITAL‐COLORADO SPRINGS 6001 EAST WOODMEN ROAD, 6TH FLOOR COLORADO SPRINGS CO 80923 EL PASO 7195716101 062017 NORTHERN COLORADO LONG TERM ACUTE HOSP ‐ LONG 4401 UNION STREET JOHNSTOWN CO 80534 LARIMER 9706193400 TERM 063027 SPALDING REHABILITATION HOSPITAL 900 POTOMAC STREET AURORA CO 80011 ADAMS 3033671166 063030 HEALTHSOUTH REHABILITATION HOSPITAL OF CO SPGS 325 PARKSIDE DRIVE COLORADO SPRINGS CO 80910 EL PASO 7196308000
063033 NORTHERN COLORADO REHABILITATION HOSPITAL INC 4401 UNION STREET JOHNSTOWN CO 80534 WELD 9706193400
063034 HEALTHSOUTH REHABILITATION HOSPITAL OF LITTLETON 1001 WEST MINERAL AVENUE LITTLETON CO 80120 ARAPAHOE 3033341100
063301 CHILDRENS HOSPITAL COLORADO 13123 EAST 16TH AVENUE AURORA CO 80045 ADAMS 7207771234 064001 COLORADO MENTAL HEALTH INSTITUTE AT PUEBLO‐PSYCH 1600 WEST 24TH ST PUEBLO CO 81003 PUEBLO 7195464443
064003 COLORADO MENTAL HEALTH INSTITUTE AT FT LOGAN 3520 W OXFORD AVE DENVER CO 80236 3038667066 064007 CENTENNIAL PEAKS HOSPITAL 2255 S 88TH ST LOUISVILLE CO 80027 BOULDER 3036739990 064009 CEDAR SPRINGS BEHAVIORAL HEALTH SYSTEM 2135 SOUTHGATE RD COLORADO SPRINGS CO 80906 EL PASO 7196334114 064023 WEST SPRINGS HOSPITAL 515 28 3/4 ROAD GRAND JUNCTION CO 81501 MESA 9702634918 064024 HIGHLANDS BEHAVIORAL HEALTH SYSTEM 8565 S POPLAR WAY LITTLETON CO 80130 DOUGLAS 7203482800 064025 HAVEN BEHAVIORAL HOSPITAL OF SOUTHERN COLO 1008 MINNEQUA AVENUE SUITE 6100 PUEBLO CO 81004 PUEBLO 7195466000 064026 PEAK VIEW BEHAVIORAL HEALTH 7353 SISTERS GROVE COLORADO SPRINGS CO 80918 EL PASO 7194448484 064027 CLEAR VIEW BEHAVIORAL HEALTH 4770 LARIMER PARKWAY JOHNSTOWN CO 80534 LARIMER 9704615061 069864 CENTURA HEALTH‐PORTER ADVENTIST HOSPITAL 2535 SOUTH DOWNING STREET #380 DENVER CO 80210 3037785671 069865 PRESBYTERIAN ST LUKE'S MEDICAL CENTER 1719 EAST 19TH AVENUE DENVER CO 80218 3038396100 069866 UNIVERSITY OF COLORADO HOSPITAL ANSCHUTZ 12605 EAST 16TH AVENUE AURORA CO 80045 ADAMS 7208487800 INPATIENT 069867 CHILDRENS HOSPITAL ASSOCIATION THE 13123 EAST 16TH AVENUE AURORA CO 80045 ADAMS 3038618888 070002 ST FRANCIS HOSPITAL & MEDICAL CENTER 114 WOODLAND STREET HARTFORD CT 06105 8607144000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 35 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 070003 DAY KIMBALL HOSPITAL 320 POMFRET STREET PUTNAM CT 06260 8609286541 070004 SHARON HOSPITAL 50 HOSPITAL HILL ROAD, PO BOX 789 SHARON CT 06069 8603644228 070005 WATERBURY HOSPITAL 64 ROBBINS ST WATERBURY CT 06721 2035736000 070006 STAMFORD HOSPITAL 30 SHELBURNE ROAD STAMFORD CT 06904 2032761000 070007 LAWRENCE & MEMORIAL HOSPITAL 365 MONTAUK AVE NEW LONDON CT 06320 8604420711 070008 JOHNSON MEMORIAL HOSPITAL 201 CHESTNUT HILL ROAD STAFFORD SPRINGS CT 06076 8606844251 070010 BRIDGEPORT HOSPITAL 267 GRANT STREET BRIDGEPORT CT 06610 2033843000 070011 CHARLOTTE HUNGERFORD HOSPITAL 540 LITCHFIELD ST TORRINGTON CT 06790 8604966666 070012 ROCKVILLE GENERAL HOSPITAL 31 UNION ST ROCKVILLE CT 06066 8608725160 070016 SAINT MARYS HOSPITAL 56 FRANKLIN ST WATERBURY CT 06706 2035746000 070017 MIDSTATE MEDICAL CENTER 435 LEWIS AVENUE MERIDEN CT 06450 2036948200 070018 GREENWICH HOSPITAL ASSOCIATION 5 PERRYRIDGE RD GREENWICH CT 06830 2038633000 070019 MILFORD HOSPITAL, INC 300 SEASIDE AVENUE MILFORD CT 06460 2038764000 07001F US COAST GUARD ACADEMY HOSP MOHEGAN AVE NEW LONDON CT 06320 070020 MIDDLESEX HOSPITAL 28 CRESCENT ST MIDDLETOWN CT 06457 8603446000 070021 WINDHAM COMM MEM HOSP & HATCH HOSP 112 MANSFIELD AVENUE WILLIMANTIC CT 06226 8604569116 070022 YALE‐NEW HAVEN HOSPITAL 20 YORK ST NEW HAVEN CT 06504 2036884242 070024 WILLIAM W BACKUS HOSPITAL 326 WASHINGTON ST NORWICH CT 06360 8608898331 070025 HARTFORD HOSPITAL 80 SEYMOUR STREET HARTFORD CT 06102 8605455000 070027 MANCHESTER MEMORIAL HOSPITAL 71 HAYNES ST MANCHESTER CT 06040 8606474780 070028 ST VINCENT'S MEDICAL CENTER 2800 MAIN ST BRIDGEPORT CT 06606 2035765551 070029 BRISTOL HOSPITAL BREWSTER RD BRISTOL CT 06010 8605853000 07002F VA HOSP 555 WILLARD AVE NEWINGTON CT 06111 070031 GRIFFIN HOSPITAL 130 DIVISION ST DERBY CT 06418 2037327500 070033 DANBURY HOSPITAL 24 HOSPITAL AVE DANBURY CT 06810 2037397000 070034 NORWALK HOSPITAL ASSOCIATION 24 STEVENS STREET NORWALK CT 06856 2038522000 070035 HOSPITAL OF CENTRAL CONNECTICUT, THE 100 GRAND STREET NEW BRITAIN CT 06050 8602245011 070036 JOHN DEMPSEY HOSPITAL 263 FARMINGTON AVE FARMINGTON CT 06032 8606791145 070038 CONNECTICUT HOSPICE INC,THE 100 DOUBLE BEACH ROAD BRANFORD CT 06405 2033157500 070039 MASONICARE HEALTH CENTER 22 MASONIC AVE WALLINGFORD CT 06492 2036795900
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 36 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 07003F VETERANS ADMINISTRATION HOSPITAL WEST SPRING ST WEST HAVEN CT 06516 070040 HEBREW HOME AND HOSPITAL INC 1 ABRAHMS BOULEVARD WEST HARTFORD CT 06117 8605233800 07004F US NAVAL HOSP P O BOX 600 GROTON CT 06340 07006E HILLSIDE HOME HOSP BOND ST EXT BRIDGEPORT CT 06610 07007E CONNECTICUT MENTAL HEALTH CENTER 34 PARK ST NEW HAVEN CT 06508 072003 GAYLORD HOSPITAL INC GAYLORD FARM RD WALLINGFORD CT 06492 2032842800 072004 HOSPITAL FOR SPECIAL CARE 2150 CORBIN AVE NEW BRITAIN CT 06050 8602232761 072006 STATE OF CONNECTICUT, DEPT OF VETERANS' AFFAIRS 287 WEST STREET ROCKY HILL CT 06067 8605292571
073025 MOUNT SINAI REHABILITATION HOSPITAL INC 490 BLUE HILLS AVENUE HARTFORD CT 06112 8607143500 073300 CONNECTICUT CHILDRENS MEDICAL CENTER 282 WASHINGTON STREET HARTFORD CT 06106 8605459000 074003 CONNECTICUT VALLEY HOSP SILVER ST MIDDLETOWN CT 06457 2033442666 074008 NATCHAUG HOSPITAL 189 STORRS RD MANSFIELD CENTER CT 06250 8604561311 074011 CONNECTICUT MENTAL HEALTH CENTER 34 PARK ST NEW HAVEN CT 06508 2039743000 074012 SOUTHWEST CONNECTICUT MENTAL HEALTH 1635 CENTRAL AVE BRIDGEPORT CT 06610 2035796646 074014 SILVER HILL HOSPITAL INC 208 VALLEY ROAD NEW CANAAN CT 06840 2039663561 074015 ALBERT J SOLNIT CHILDREN'S CENTER ‐ SOUTH CAMPUS 915 RIVER ROAD MIDDLETOWN CT 06457 8607044090
079801 YALE‐NEW HAVEN HOSPITAL ‐ TRANSPLANT CENTER 20 YORK STREET NEW HAVEN CT 06504 2037852611 079802 HARTFORD HOSPITAL ‐ TRANSPLANT CENTER 80 SEYMOUR STREET, PO BOX 5037 HARTFORD CT 06106 8605454339 080001 CHRISTIANA CARE HEALTH SERVICES, INC. 4755 OGLETOWN‐STANTON ROAD NEWARK DE 19718 NEW CASTLE 3027331000 080003 ST FRANCIS HOSPITAL 7TH AND CLAYTON STS WILMINGTON DE 19805 NEW CASTLE 3024214100 080004 BAYHEALTH ‐ KENT GENERAL HOSPITAL 640 S STATE STREET DOVER DE 19901 KENT 3027447001 080006 NANTICOKE MEMORIAL HOSPITAL 801 MIDDLEFORD RD SEAFORD DE 19973 SUSSEX 3026296611 080007 BEEBE MEDICAL CENTER 424 SAVANNAH RD LEWES DE 19958 SUSSEX 3026453300 080009 BAYHEALTH ‐ MILFORD MEMORIAL HOSPITAL 21 WEST CLARKE AVENUE MILFORD DE 19963 SUSSEX 3024223311 08001F US AIR FORCE HOSP 300 TUSKEGEE BLVD DOVER DE 19902 KENT 3026772858 08002F WILMINGTON VA MEDICAL & REGIONAL OFFICE CENTER 1601 KIRKWOOD HIGHWAY WILMINGTON DE 19805 NEW CASTLE 3029942511
082000 SELECT SPECIALTY HOSPITAL WILMINGTON 7TH & CLAYTON STREETS 5TH FLOOR WILMINGTON DE 19805 NEW CASTLE 3024214591 083026 HEALTHSOUTH REHABILITATION HOSPITAL OF 250 EAST HAMPDEN ROAD MIDDLETOWN DE 19709 NEW CASTLE 4848899815 MIDDLETOWN
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 37 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 083300 ALFRED I DUPONT HOSPITAL FOR CHILDREN 1600 ROCKLAND RD PO BOX 269 WILMINGTON DE 19899 NEW CASTLE 3026514000 084001 DELAWARE PSYCHIATRIC CENTER 1901 N DUPONT HIGHWAY NEW CASTLE DE 19720 NEW CASTLE 3022552700 084002 ROCKFORD CENTER 100 ROCKFORD DRIVE NEWARK DE 19713 NEW CASTLE 3029965480 084003 MEADOWWOOD BEHAVIORAL HEALTH SYSTEM 575 SOUTH DUPONT HIGHWAY NEW CASTLE DE 19720 NEW CASTLE 3023283330 084004 DOVER BEHAVIORAL HEALTH SYSTEM 725 HORSEPOND ROAD DOVER DE 19901 KENT 3027410140 089800 CHRISTIANA CARE HEALTH SYSTEM 4735 OGLETOWN‐STANTON ROAD NEWARK DE 19718 NEW CASTLE 3026233866 089801 ALFRED I DUPONT HOSPITAL FOR CHILDREN 1600 ROCKLAND ROAD, BOX 269 WILMINGTON DE 19899 NEW CASTLE 3026514000 090001 GEORGE WASHINGTON UNIV HOSPITAL 900 23RD ST NW WASHINGTON DC 20037 2027164605 090003 HOWARD UNIVERSITY HOSPITAL 2041 GEORGIA AVE NW WASHINGTON DC 20060 2027456100 090004 MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL 3800 RESERVOIR RD WASHINGTON DC 20007 2027843000 090005 SIBLEY MEMORIAL HOSPITAL 5255 LOUGHBORO RD NW WASHINGTON DC 20016 2025374680 090006 PROVIDENCE HOSPITAL 1150 VARNUM ST NE WASHINGTON DC 20017 2022697000 090008 UNITED MEDICAL CENTER 1310 SOUTHERN AVENUE SE WASHINGTON DC 20032 2025746611 090011 MEDSTAR WASHINGTON HOSPITAL CENTER 110 IRVING ST NW WASHINGTON DC 20010 2028777000 09001F US AIR FORCE HOSP ANDREWS AFB WASHINGTON DC 20331 09002F WASHINGTON DC VA MEDICAL CENTER 50 IRVING ST NW WASHINGTON DC 20422 2027458000 09003F WALTER REED ARMY HOSP 6825 16TH ST NW WASHINGTON DC 20012 092002 BRIDGEPOINT HOSPITAL CAPITOL HILL 700 CONSTITUTION AVENUE NE WASHINGTON DC 20002 2026750400 092003 BRIDGEPOINT HOSPITAL HADLEY 4601 MARTIN LUTHER KING JR AVENUE WASHINGTON DC 20032 2025745770 093025 MEDSTAR NATIONAL REHABILITATION HOSPITAL 102 IRVING STREET NW WASHINGTON DC 20010 2028771737 093300 CHILDREN'S HOSPITAL NMC 111 MICHIGAN AVE, NW WASHINGTON DC 20010 2024765000 094001 ST ELIZABETHS HOSPITAL 1100 ALABAMA AVENUE, SE WASHINGTON DC 20032 2022995500 094004 PSYCHIATRIC INSTITUTE OF WASHINGTON DC 4228 WISCONSIN AVENUE, NW WASHINGTON DC 20016 2028855600 099800 MEDSTAR WASHINGTON HOSPITAL CENTER 110 IRVING ST, NW WASHINGTON DC 20010 2028776102 099801 CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVE NW WASHINGTON DC 20010 2028845058 099802 MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL 3800 RESERVOIR RD NW, STE 2 MAIN WASHINGTON DC 20007 2024448054 099803 GEORGE WASHINGTON UNIVERSITY HOSPITAL 900 23RDSTREET WASHINGTON DC 20037 2027154225 100001 UF HEALTH JACKSONVILLE 655 W 8TH ST JACKSONVILLE FL 32209 9042440411 100002 BETHESDA HOSPITAL EAST 2815 S SEACREST BLVD BOYNTON BEACH FL 33435 PALM BEACH 5617377733 100006 ORLANDO HEALTH 52 W UNDERWOOD ST ORLANDO FL 32806 ORANGE 3218438000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 38 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 100007 FLORIDA HOSPITAL 601 E ROLLINS ST ORLANDO FL 32803 ORANGE 4073031976 100008 BAPTIST HOSPITAL OF MIAMI 8900 N KENDALL DR MIAMI FL 33176 MIAMI‐DADE 7865961960 100009 UNIVERSITY OF MIAMI HOSPITAL 1400 NW 12TH AVE MIAMI FL 33136 MIAMI‐DADE 3053255511 100012 LEE MEMORIAL HOSPITAL 2776 CLEVELAND AVE FORT MYERS FL 33901 LEE 2393321111 100014 FLORIDA HOSPITAL NEW SMYRNA 401 PALMETTO ST NEW SMYRNA BEACH FL 32170 VOLUSIA 3864245000 100017 HALIFAX HEALTH MEDICAL CENTER 303 N CLYDE MORRIS BLVD DAYTONA BEACH FL 32114 VOLUSIA 3862544000 100018 NAPLES COMMUNITY HOSPITAL 350 7TH ST N NAPLES FL 34102 COLLIER 2394365000 100019 HOLMES REGIONAL MEDICAL CENTER 1350 S HICKORY ST MELBOURNE FL 32901 BREVARD 3214347000 100022 JACKSON MEMORIAL HOSPITAL 1611 NW 12TH AVE MIAMI FL 33136 MIAMI‐DADE 3055851111 100023 CITRUS MEMORIAL HOSPITAL 502 W HIGHLAND BLVD INVERNESS FL 34452 CITRUS 3527261551 100025 SACRED HEART HOSPITAL 5151 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA 8504167000 100026 BAY MEDICAL CENTER SACRED HEART HEALTH SYSTEM 615 N BONITA AVE PANAMA CITY FL 32401 BAY 8507691511
100028 PARRISH MEDICAL CENTER 951 N WASHINGTON AVE TITUSVILLE FL 32796 BREVARD 3212686111 100029 NORTH SHORE MEDICAL CENTER 1100 NW 95TH ST MIAMI FL 33150 MIAMI‐DADE 3058356000 100030 HEALTH CENTRAL 10000 W COLONIAL DR OCOEE FL 34761 ORANGE 4072961820 100032 BAYFRONT HEALTH ‐ ST PETERSBURG 701 6TH ST S SAINT PETERSBURG FL 33701 PINELLAS 7278231234 100034 MOUNT SINAI MEDICAL CENTER 4300 ALTON RD MIAMI BEACH FL 33140 MIAMI‐DADE 3056742121 100035 MANATEE MEMORIAL HOSPITAL 206 2ND ST E BRADENTON FL 34208 MANATEE 9417465111 100038 MEMORIAL REGIONAL HOSPITAL 3501 JOHNSON ST HOLLYWOOD FL 33021 BROWARD 9549872000 100039 BROWARD HEALTH MEDICAL CENTER 1600 S ANDREWS AVE FORT LAUDERDALE FL 33316 BROWARD 9543554400 100040 ST VINCENT'S MEDICAL CENTER RIVERSIDE 1 SHIRCLIFF WAY JACKSONVILLE FL 32204 9043087300 100043 MEASE DUNEDIN HOSPITAL 601 MAIN ST DUNEDIN FL 34698 PINELLAS 7277331111 100044 MARTIN MEDICAL CENTER 200 SE HOSPITAL AVE STUART FL 34995 MARTIN 7722875200 100045 FLORIDA HOSPITAL DELAND 701 W PLYMOUTH AVE DELAND FL 32720 VOLUSIA 3869434772 100046 FLORIDA HOSPITAL ZEPHYRHILLS 7050 GALL BLVD ZEPHYRHILLS FL 33541 PASCO 8137880411 100047 BAYFRONT HEALTH PUNTA GORDA 809 E MARION AVE PUNTA GORDA FL 33950 CHARLOTTE 9416393131 100048 JAY HOSPITAL 14114 ALABAMA ST JAY FL 32565 SANTA ROSA 8506754532 100049 HIGHLANDS REGIONAL MEDICAL CENTER 3600 S HIGHLANDS AVE SEBRING FL 33870 HIGHLANDS 8633856101 100050 LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS 1475 W 49TH ST HIALEAH FL 33012 MIAMI‐DADE 3055582500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 39 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 100051 SOUTH LAKE HOSPITAL 1900 DON WICKHAM DR CLERMONT FL 34711 LAKE 3523944071 100052 WINTER HAVEN HOSPITAL 200 AVE F NE WINTER HAVEN FL 33881 POLK 8632931121 100053 HIALEAH HOSPITAL 651 E 25TH ST HIALEAH FL 33013 MIAMI‐DADE 3056936100 100054 TWIN CITIES HOSPITAL 2190 HWY 85 N NICEVILLE FL 32578 OKALOOSA 8506784131 100055 FLORIDA HOSPITAL NORTH PINELLAS 1395 S PINELLAS AVE TARPON SPRINGS FL 34689 PINELLAS 7279425000 100057 FLORIDA HOSPITAL WATERMAN 1000 WATERMAN WAY TAVARES FL 32778 LAKE 3522533300 100062 MUNROE REGIONAL MEDICAL CENTER 1500 SW 1ST AVE OCALA FL 34474 MARION 3523517200 100063 MORTON PLANT NORTH BAY HOSPITAL 6600 MADISON ST NEW PORT RICHEY FL 34652 PASCO 7278428468 100067 ST ANTHONYS HOSPITAL 1200 SEVENTH AVE N SAINT PETERSBURG FL 33705 PINELLAS 7278251100 100068 FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH FL 32117 VOLUSIA 3866766000 100069 FLORIDA HOSPITAL CARROLLWOOD 7171 N DALE MABRY HWY TAMPA FL 33614 HILLSBOROUGH 8139322222 100070 VENICE REGIONAL MEDICAL CENTER ‐ BAYFRONT HEALTH 540 THE RIALTO VENICE FL 34285 SARASOTA 9414857711
100071 BAYFRONT HEALTH BROOKSVILLE 17240 CORTEZ BLVD BROOKSVILLE FL 34601 HERNANDO 3527965111 100072 FLORIDA HOSPITAL FISH MEMORIAL 1055 SAXON BLVD ORANGE CITY FL 32763 VOLUSIA 3869175000 100073 HOLY CROSS HOSPITAL 4725 N FEDERAL HWY FORT LAUDERDALE FL 33308 BROWARD 9547718000 100075 ST JOSEPHS HOSPITAL 3001 W MARTIN LUTHER KING JR BLVD TAMPA FL 33677 HILLSBOROUGH 8138704398 100077 BAYFRONT HEALTH PORT CHARLOTTE 2500 HARBOR BLVD PORT CHARLOTTE FL 33952 CHARLOTTE 9417664122 100079 UNIVERSITY OF MIAMI HOSPITAL AND CLINICS 1475 NW 12TH AVE MIAMI FL 33136 MIAMI‐DADE 3052431000 100080 JFK MEDICAL CENTER 5301 S CONGRESS AVE ATLANTIS FL 33462 PALM BEACH 5619657300 100081 HEALTHMARK REGIONAL MEDICAL CENTER 4413 US HWY 331 SDEFUNIAK SPRINGS FL 32435 WALTON 8509514500 100084 LEESBURG REGIONAL MEDICAL CENTER 600 E DIXIE AVE LEESBURG FL 34748 LAKE 3523235762 100086 BROWARD HEALTH NORTH 201 E SAMPLE RD POMPANO BEACH FL 33064 BROWARD 9547866950 100087 SARASOTA MEMORIAL HOSPITAL 1700 S TAMIAMI TRL SARASOTA FL 34239 SARASOTA 9419179000 100088 BAPTIST MEDICAL CENTER JACKSONVILLE 800 PRUDENTIAL DR JACKSONVILLE FL 32207 9042022000 100090 FLAGLER HOSPITAL 400 HEALTH PARK BLVD SAINT AUGUSTINE FL 32086 ST. JOHNS 9048194426 100092 WUESTHOFF MEDICAL CENTER‐ROCKLEDGE 110 LONGWOOD AVE ROCKLEDGE FL 32955 BREVARD 3216372603 100093 BAPTIST HOSPITAL 1000 W MORENO ST PENSACOLA FL 32501 ESCAMBIA 8504344011 100099 LAKE WALES MEDICAL CENTER 410 S 11TH ST LAKE WALES FL 33853 POLK 8636761433 10009F BAY PINES VA MEDICAL CENTER 10000 BAY PINES BLVD SAINT PETERSBURG FL 33708 PINELLAS 7273986661
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 40 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 100102 SHANDS LAKE SHORE REGIONAL MEDICAL CENTER 368 NE FRANKLIN ST LAKE CITY FL 32055 COLUMBIA 3862928000 100105 INDIAN RIVER MEDICAL CENTER 1000 36TH ST VERO BEACH FL 32960 INDIAN RIVER 7725674311 100106 DOCTOR'S MEMORIAL HOSPITAL INC 333 N BYRON BUTLER PKWY PERRY FL 32348 TAYLOR 8505840800 100107 LEHIGH REGIONAL MEDICAL CENTER 1500 LEE BLVD LEHIGH ACRES FL 33936 LEE 2393692101 100109 FLORIDA HOSPITAL HEARTLAND MEDICAL CENTER 4200 SUN N LAKE BLVD SEBRING FL 33871 HIGHLANDS 8633144466 10010F US AIR FORCE HOSP PATRICK AFB COCOA FL 32922 BREVARD 100110 OSCEOLA REGIONAL MEDICAL CENTER 700 WEST OAK STREET KISSIMMEE FL 34741 OSCEOLA 4078462266 100113 UF HEALTH SHANDS HOSPITAL 1600 SW ARCHER RD GAINESVILLE FL 32610 ALACHUA 3522658000 100117 BAPTIST MEDICAL CENTER ‐ BEACHES 1350 13TH AVE S JACKSONVILLE BEACH FL 32250 9042472900 100118 FLORIDA HOSPITAL FLAGLER 60 MEMORIAL MEDICAL PKWY PALM COAST FL 32164 FLAGLER 3865862000 100121 BARTOW REGIONAL MEDICAL CENTER 2200 OSPREY BLVD BARTOW FL 33831 POLK 8635338111 100122 NORTH OKALOOSA MEDICAL CENTER 151 REDSTONE AVE SE CRESTVIEW FL 32539 OKALOOSA 8506898100 100124 SANTA ROSA MEDICAL CENTER 6002 BERRYHILL RD MILTON FL 32570 SANTA ROSA 8506267762 100125 HOMESTEAD HOSPITAL 975 BAPTIST WAY HOMESTEAD FL 33033 MIAMI‐DADE 7862438000 100126 PALMS OF PASADENA HOSPITAL 1501 PASADENA AVE S SAINT PETERSBURG FL 33707 PINELLAS 7273811000 100127 MORTON PLANT HOSPITAL 300 PINELLAS ST CLEARWATER FL 33756 PINELLAS 7274627000 100128 TAMPA GENERAL HOSPITAL 1 TAMPA GENERAL CIR TAMPA FL 33606 HILLSBOROUGH 8138447000 10012F US AIR FORCE HOSP HOMESTEAD AFB HOMESTEAD FL 33030 MIAMI‐DADE 3059999999 100130 LAKESIDE MEDICAL CENTER 39200 HOOKER HWY BELLE GLADE FL 33430 PALM BEACH 5619966571 100131 AVENTURA HOSPITAL AND MEDICAL CENTER 20900 BISCAYNE BLVD AVENTURA FL 33180 MIAMI‐DADE 3056827000 100132 SOUTH FLORIDA BAPTIST HOSPITAL 301 N ALEXANDER ST PLANT CITY FL 33563 HILLSBOROUGH 8137571200 100134 ED FRASER MEMORIAL HOSPITAL 159 N 3RD ST MACCLENNY FL 32063 BAKER 9042593151 100135 TALLAHASSEE MEMORIAL HOSPITAL 1300 MICCOSUKEE RD TALLAHASSEE FL 32308 LEON 8504311155 100137 HEART OF FLORIDA REGIONAL MEDICAL CENTER 40100 US HWY 27 N DAVENPORT FL 33837 POLK 8634224971 10013F US NAVAL HOSP JACKSONVILLE FL 32214 100140 BAPTIST MEDICAL CENTER ‐ NASSAU 1250 S 18TH ST FERNANDINA BEACH FL 32034 NASSAU 9043213500 100142 JACKSON HOSPITAL 4250 HOSPITAL DR MARIANNA FL 32446 JACKSON 8507182620 10014F US NAVAL HOSP KEY WEST FL 33040 MONROE 100150 LOWER KEYS MEDICAL CENTER 5900 COLLEGE ROAD KEY WEST FL 33040 MONROE 3052945531 100151 MAYO CLINIC 4500 SAN PABLO RD JACKSONVILLE FL 32224 9049532000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 41 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 100154 SOUTH MIAMI HOSPITAL 6200 SW 73RD ST SOUTH MIAMI FL 33143 MIAMI‐DADE 7866624000 100156 LAKE CITY MEDICAL CENTER 340 NW COMMERCE DR LAKE CITY FL 32055 COLUMBIA 3867199000 100157 LAKELAND REGIONAL MEDICAL CENTER 1324 LAKELAND HILLS BLVD LAKELAND FL 33805 POLK 8636871100 10015F NORTH FL/SOUTH GA VETERANS HEALTH SYSTE 619 S MARION ST LAKE CITY FL 32025 COLUMBIA 3867553016 100161 CENTRAL FLORIDA REGIONAL HOSPITAL 1401 W SEMINOLE BLVD SANFORD FL 32771 SEMINOLE 4073214500 100166 DOCTORS HOSPITAL OF SARASOTA 5731 BEE RIDGE RD SARASOTA FL 34233 SARASOTA 9413421100 100167 PLANTATION GENERAL HOSPITAL 401 NW 42ND AVE PLANTATION FL 33317 BROWARD 9545875010 100168 BOCA RATON REGIONAL HOSPITAL 800 MEADOWS RD BOCA RATON FL 33486 PALM BEACH 5613625002 10016F US NAVEL HOSP ORLANDO AFB ORLANDO FL 32813 ORANGE 100173 FLORIDA HOSPITAL TAMPA 3100 E FLETCHER AVE TAMPA FL 33613 HILLSBOROUGH 8136157200 100175 DESOTO MEMORIAL HOSPITAL 900 N ROBERT AVE ARCADIA FL 34265 DESOTO 8634943535 100176 PALM BEACH GARDENS MEDICAL CENTER 3360 BURNS RD PALM BEACH GARDENS FL 33410 PALM BEACH 5616221411 100177 CAPE CANAVERAL HOSPITAL 701 W COCOA BEACH CAUSEWAY COCOA BEACH FL 32932 BREVARD 3217997111 100179 MEMORIAL HOSPITAL JACKSONVILLE 3625 UNIVERSITY BLVD S JACKSONVILLE FL 32216 9043996111 10017F US AIR FORCE HOSP TYNDALL AFB PANAMA CITY FL 32401 BAY 8509999999 100180 ST PETERSBURG GENERAL HOSPITAL 6500 38TH AVE N SAINT PETERSBURG FL 33710 PINELLAS 7273841414 100181 LARKIN COMMUNITY HOSPITAL 7031 SW 62ND AVE SOUTH MIAMI FL 33143 MIAMI‐DADE 3052847500 100183 CORAL GABLES HOSPITAL 3100 DOUGLAS RD CORAL GABLES FL 33134 MIAMI‐DADE 3054458461 100187 PALMETTO GENERAL HOSPITAL 2001 W 68TH ST HIALEAH FL 33016 MIAMI‐DADE 3058235000 100189 NORTHWEST MEDICAL CENTER 2801 N STATE RD 7 MARGATE FL 33063 BROWARD 9549740400 10018F US NAVAL HOSP PENSACOLA FL 32512 ESCAMBIA 100191 MEDICAL CENTER OF TRINITY 9330 SR 54, STE 401 TRINITY FL 34655 PASCO 7278481733 10019F FEDERAL CORRECTIONAL INST HOSP TALLAHASSEE FL 32304 LEON 100200 BROWARD HEALTH IMPERIAL POINT 6401 N FEDERAL HWY FORT LAUDERDALE FL 33308 BROWARD 9547768500 100204 NORTH FLORIDA REGIONAL MEDICAL CENTER 6500 NEWBERRY RD GAINESVILLE FL 32605 ALACHUA 3523334100 100206 MEMORIAL HOSPITAL OF TAMPA 2901 W SWANN AVE TAMPA FL 33609 HILLSBOROUGH 8138736400 100209 KENDALL REGIONAL MEDICAL CENTER 11750 BIRD RD MIAMI FL 33175 MIAMI‐DADE 3052233000 10020F US AIR FORCE HOSP MACDILL AFB TAMPA FL 33608 HILLSBOROUGH 100211 BAYFRONT HEALTH DADE CITY 13100 FT KING RD DADE CITY FL 33525 PASCO 3525683174 100212 OCALA REGIONAL MEDICAL CENTER 1431 SW 1ST AVE OCALA FL 34478 MARION 3524011000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 42 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 100213 BLAKE MEDICAL CENTER 2020 59TH ST W BRADENTON FL 34209 MANATEE 9417926611 100217 SEBASTIAN RIVER MEDICAL CENTER 13695 US HWY 1 SEBASTIAN FL 32978 INDIAN RIVER 7725893187 10021F US AIR FORCE HOSP ELGIN AFB VALPASAISO FL 32580 OKALOOSA 100220 GULF COAST MEDICAL CENTER LEE MEM HEALTH SYSTEM 13681 DOCTORS WAY FORT MYERS FL 33912 LEE 2397685000
100223 FORT WALTON BEACH MEDICAL CENTER 1000 MAR‐WALT DR FORT WALTON BEACH FL 32547 OKALOOSA 8508621111 100224 UNIVERSITY HOSPITAL AND MEDICAL CENTER 7201 N UNIVERSITY DR TAMARAC FL 33321 BROWARD 9547212200 100226 ORANGE PARK MEDICAL CENTER 2001 KINGSLEY AVE ORANGE PARK FL 32073 CLAY 9042768500 100228 WESTSIDE REGIONAL MEDICAL CENTER 8201 W BROWARD BLVD PLANTATION FL 33324 BROWARD 9544736600 100230 MEMORIAL HOSPITAL PEMBROKE 7800 SHERIDAN ST PEMBROKE PINES FL 33024 BROWARD 9549629650 100231 WEST FLORIDA HOSPITAL 8383 N DAVIS HWY PENSACOLA FL 32514 ESCAMBIA 8504944000 100232 PUTNAM COMMUNITY MEDICAL CENTER 611 ZEAGLER DR PALATKA FL 32177 PUTNAM 3863268500 100234 WEST PALM HOSPITAL 2201 45TH ST WEST PALM BEACH FL 33407 PALM BEACH 5618446141 100236 FAWCETT MEMORIAL HOSPITAL 21298 OLEAN BLVD PORT CHARLOTTE FL 33952 CHARLOTTE 9416291181 100238 NORTHSIDE HOSPITAL 6000 49TH ST N SAINT PETERSBURG FL 33709 PINELLAS 8135215000 100240 ANNE BATES LEACH EYE HOSPITAL 900 NW 17TH ST MIAMI FL 33136 MIAMI‐DADE 3053266000 100242 GULF COAST REGIONAL MEDICAL CENTER 449 W 23RD ST PANAMA CITY FL 32405 BAY 8507477926 100243 BRANDON REGIONAL HOSPITAL 119 OAKFIELD DR BRANDON FL 33511 HILLSBOROUGH 8136815551 100244 CAPE CORAL HOSPITAL 636 DEL PRADO BLVD CAPE CORAL FL 33990 LEE 2395742323 100246 LAWNWOOD REGIONAL MEDICAL CENTER & HEART 1700 S 23RD ST FORT PIERCE FL 34950 ST. LUCIE 7724614000 INSTITUTE 100248 LARGO MEDICAL CENTER 201 14TH ST SW LARGO FL 33770 PINELLAS 7275885200 100249 SEVEN RIVERS REGIONAL MEDICAL CENTER 6201 N SUNCOAST BLVD CRYSTAL RIVER FL 34428 CITRUS 3527956560 100252 RAULERSON HOSPITAL 1796 HWY 441 NORTH OKEECHOBEE FL 34972 OKEECHOBEE 8637632151 100253 JUPITER MEDICAL CENTER 1210 S OLD DIXIE HWY JUPITER FL 33458 PALM BEACH 5617472234 100254 CAPITAL REGIONAL MEDICAL CENTER 2626 CAPITAL MEDICAL BLVD TALLAHASSEE FL 32308 LEON 8506565000 100255 TAMPA COMMUNITY HOSPITAL 6001 WEBB RD TAMPA FL 33615 HILLSBOROUGH 8138827159 100256 REGIONAL MEDICAL CENTER BAYONET POINT 14000 FIVAY RD HUDSON FL 34667 PASCO 7278192929 100258 DELRAY MEDICAL CENTER 5352 LINTON BLVD DELRAY BEACH FL 33484 PALM BEACH 5614984440 100259 SOUTH BAY HOSPITAL 4016 SUN CITY CENTER BLVD SUN CITY CENTER FL 33573 HILLSBOROUGH 8136343301 100260 ST LUCIE MEDICAL CENTER 1800 SE TIFFANY AVE PORT SAINT LUCIE FL 34952 ST. LUCIE 7723354000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 43 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 100264 OAK HILL HOSPITAL 11375 CORTEZ BLVD BROOKSVILLE FL 34613 HERNANDO 3525966632 100265 MEASE COUNTRYSIDE HOSPITAL 3231 MCMULLEN BOOTH RD SAFETY HARBOR FL 34695 PINELLAS 7277346950 100266 GULF BREEZE HOSPITAL 1110 GULF BREEZE PKWY GULF BREEZE FL 32561 SANTA ROSA 8509342000 100267 ENGLEWOOD COMMUNITY HOSPITAL 700 MEDICAL BLVD ENGLEWOOD FL 34223 SARASOTA 9414756571 100268 WEST BOCA MEDICAL CENTER 21644 STATE RD 7BOCA RATON FL 33428 PALM BEACH 5614888000 100269 PALMS WEST HOSPITAL 13001 SOUTHERN BLVD LOXAHATCHEE FL 33470 PALM BEACH 5617534245 100271 H LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE I 12902 MAGNOLIA DR TAMPA FL 33612 HILLSBOROUGH 8139793054
100275 WELLINGTON REGIONAL MEDICAL CENTER 10101 FOREST HILL BLVD WELLINGTON FL 33414 PALM BEACH 5617988500 100276 BROWARD HEALTH CORAL SPRINGS 3000 CORAL HILLS DR CORAL SPRINGS FL 33065 BROWARD 9543443000 100277 DOUGLAS GARDENS HOSPITAL 5200 NE 2ND AVE MIAMI FL 33137 MIAMI‐DADE 3057518626 100281 MEMORIAL HOSPITAL WEST 703 N FLAMINGO RD PEMBROKE PINES FL 33028 BROWARD 9544365000 100284 WESTCHESTER GENERAL HOSPITAL 2500 SW 75TH AVE MIAMI FL 33155 MIAMI‐DADE 3052639270 100285 MEMORIAL HOSPITAL MIRAMAR 1901 SW 172ND AVE MIRAMAR FL 33029 BROWARD 9545384810 100286 PHYSICIANS REGIONAL MEDICAL CENTER ‐ PINE RIDGE 6101 PINE RIDGE ROAD NAPLES FL 34119 COLLIER 2393484000
100287 GOOD SAMARITAN MEDICAL CENTER 1309 N FLAGLER DR WEST PALM BEACH FL 33401 PALM BEACH 5616555511 100288 ST MARY'S MEDICAL CENTER 901 45TH ST WEST PALM BEACH FL 33407 PALM BEACH 5618406202 100289 CLEVELAND CLINIC HOSPITAL 3100 WESTON RD WESTON FL 33331 BROWARD 9546895000 100290 VILLAGES REGIONAL HOSPITAL, THE 1451 EL CAMINO REAL THE VILLAGES FL 32159 SUMTER 3527518000 100291 WUESTHOFF MEDICAL CENTER‐MELBOURNE 250 NORTH WICKHAM ROAD MELBOURNE FL 32935 BREVARD 3217521200 100292 SACRED HEART HOSPITAL ON THE EMERALD COAST 7800 US HWY 98 W MIRAMAR BEACH FL 32550 WALTON 8502783600 100296 DOCTORS HOSPITAL 5000 UNIVERSITY DR CORAL GABLES FL 33146 MIAMI‐DADE 3056662111 100298 FLORIDA STATE HOSPITAL UNIT 31 MED 100 N MAIN ST CHATTAHOOCHEE FL 32324 GADSDEN 8506637536 100299 LAKEWOOD RANCH MEDICAL CENTER 8330 LAKEWOOD RANCH BLVD BRADENTON FL 34202 MANATEE 9417822100 100302 ST CLOUD REGIONAL MEDICAL CENTER 2906 17TH STREET SAINT CLOUD FL 34769 OSCEOLA 4074983432 100307 ST VINCENT'S MEDICAL CENTER SOUTHSIDE 4201 BELFORT RD JACKSONVILLE FL 32216 9042963700 100313 SACRED HEART HOSPITAL ON THE GULF 3801 E HWY 98 PORT SAINT JOE FL 32456 GULF 8502295600 100314 WEST KENDALL BAPTIST HOSPITAL 9555 SW 162 AVE MIAMI FL 33196 MIAMI‐DADE 7864672011 100315 VIERA HOSPITAL 8745 N WICKHAM RD MELBOURNE FL 32940 BREVARD 3214349000 100316 PALM BAY HOSPITAL 1425 MALABAR RD, NE PALM BAY FL 32907 BREVARD 3214348000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 44 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 100319 FLORIDA HOSPITAL WESLEY CHAPEL 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544 PASCO 8139295490 100320 POINCIANA MEDICAL CENTER 325 CYPRESS PKWY KISSIMMEE FL 34758 OSCEOLA 4075302000 100321 ST VINCENTS MEDICAL CENTER ‐ CLAY COUNTY 1670 ST VINCENTS WAY MIDDLEBURG FL 32068 CLAY 9043087164 100322 REGIONAL GENERAL HOSPITAL WILLISTON 125 SW 7TH ST WILLISTON FL 32696 LEVY 3525282801 100327 LANDMARK HOSPITAL OF SOUTHWEST FLORIDA 1285 CREEKSIDE BLVD E NAPLES FL 34108 COLLIER 2394788398 100328 MIAMI MEDICAL CENTER, THE 5959 NW 7TH AVE MIAMI FL 33126 MIAMI‐DADE 3052641000 10039E HOPE HAVEN CHILDRENS HOSP 5720 ATLANTIC BLVD JACKSONVILLE FL 32207 10043E FLORIDA ALCOHOLIC REHAB CENTER P O BOX 1147 AVON PARK FL 33825 HIGHLANDS 10056E VARIETY CHILDRENS HOSP 6125 SW 31ST ST MIAMI FL 33155 MIAMI‐DADE 3059999999 10057F NORTH FL/SOUTH GA VETERANS HEALTH SYSTEM 1601 SW ARCHER RD GAINESVILLE FL 32608 ALACHUA 3523761611 10063F JAMES A HALEY VA HOSPITAL 13000 BRUCE B DOWNS BLVD TAMPA FL 33612 HILLSBOROUGH 8139722000 10064F MIAMI VA MEDICAL CENTER 1201 NW 16TH ST MIAMI FL 33125 MIAMI‐DADE 3053244455 10065F WEST PALM BEACH VA MEDICAL CENTER 7305 NORTH MILITARY TRAIL WEST PALM BEACH FL 33410 PALM BEACH 5618828262 101300 FLORIDA HOSPITAL WAUCHULA 533 CARLTON ST WAUCHULA FL 33873 HARDEE 8637733101 101301 SHANDS LIVE OAK REGIONAL MEDICAL CENTER 1100 SW 11TH ST LIVE OAK FL 32060 SUWANNEE 9043621413 101302 CAMPBELLTON‐GRACEVILLE HOSPITAL 5429 COLLEGE DR GRACEVILLE FL 32440 JACKSON 8502637201 101303 LAKE BUTLER HOSPITAL 850 E MAIN ST LAKE BUTLER FL 32054 UNION 3864962323 101304 CALHOUN‐LIBERTY HOSPITAL 20370 NE BURNS AVE BLOUNTSTOWN FL 32424 CALHOUN 8506743493 101305 GEORGE E WEEMS MEMORIAL HOSPITAL 135 AVE G APALACHICOLA FL 32320 FRANKLIN 8506538853 101307 DOCTORS MEMORIAL HOSPITAL 2600 HOSPITAL DR BONIFAY FL 32425 HOLMES 8505471120 101308 NORTHWEST FLORIDA COMMUNITY HOSPITAL 1360 BRICKYARD RD CHIPLEY FL 32428 WASHINGTON 8506381610 101309 HENDRY REGIONAL MEDICAL CENTER 524 W SAGAMORE AVE CLEWISTON FL 33440 HENDRY 8639023033 101310 SHANDS STARKE REGIONAL MEDICAL CENTER 922 E CALL ST STARKE FL 32091 BRADFORD 9043682300 101311 MADISON COUNTY MEMORIAL HOSPITAL 224 NW CRANE AVE MADISON FL 32340 MADISON 8509732271 101312 FISHERMEN'S HOSPITAL 3301 OVERSEAS HWY MARATHON FL 33050 MONROE 3057435533 101313 MARINERS HOSPITAL 91500 OVERSEAS HIGHWAY TAVERNIER FL 33070 MONROE 3054343000 101993 DAYSTAR, INC 3800 SOUTH FLAMINGO ROAD FORT LAUDERDALE FL 33330 BROWARD 9544730167 102001 SELECT SPECIALTY HOSPITAL‐MIAMI 955 NW 3RD STREET 8TH FLOOR MIAMI FL 33128 MIAMI‐DADE 3054165700 102003 SELECT SPECIALTY HOSPITAL ‐ ORLANDO 5579 S ORANGE AVE ORLANDO FL 32809 ORANGE 4073031766 102009 KINDRED HOSPITAL‐BAY AREA‐TAMPA 4555 S MANHATTAN AVE TAMPA FL 33611 HILLSBOROUGH 8138396341
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 45 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 102010 KINDRED HOSPITAL‐SOUTH FLORIDA‐FT LAUDERDALE 1516 E LAS OLAS BLVD FORT LAUDERDALE FL 33301 BROWARD 9547648900
102012 SPECIALTY HOSPITAL JACKSONVILLE 4901 RICHARD ST JACKSONVILLE FL 32207 9047373120 102013 KINDRED HOSPITAL‐CENTRAL TAMPA 4801 N HOWARD AVE TAMPA FL 33603 HILLSBOROUGH 8138747575 102015 KINDRED HOSPITAL‐NORTH FLORIDA 801 OAK ST GREEN COVE SPRINGS FL 32043 CLAY 9042849230 102016 SISTER EMMANUEL HOSPITAL 3663 S MIAMI AVE, 4TH FLOOR MIAMI FL 33133 MIAMI‐DADE 3052852939 102017 SELECT SPECIALTY HOSPITAL ‐ PANAMA CITY 615 N BONITA AVE PANAMA CITY FL 32401 BAY 8507673180 102018 COMPLEX CARE HOSPITAL AT RIDGELAKE 6150 EDGELAKE DR SARASOTA FL 34240 SARASOTA 9413423200 102019 KINDRED HOSPITAL OCALA 1500 SW 1ST AVENUE, 5TH FLOOR OCALA FL 34474 MARION 3523690513 102020 SELECT SPECIALTY HOSPITAL ‐ TALLAHASSEE 1554 SURGEONS DR TALLAHASSEE FL 32308 LEON 8502196800 102021 BAYCARE ALLIANT HOSPITAL 601 MAIN ST DUNEDIN FL 34698 PINELLAS 7277346302 102022 SELECT SPECIALTY HOSPITAL GAINESVILLE INC 2708 SW ARCHER RD GAINESVILLE FL 32608 ALACHUA 3525865303 102023 SELECT SPECIALTY HOSPITAL‐PALM BEACH 3060 MELALEUCA LANE LAKE WORTH FL 33461 PALM BEACH 5613577200 102024 SELECT SPECIALTY HOSPITAL PENSACOLA 7000 COBBLE CREEK DR PENSACOLA FL 32504 ESCAMBIA 8504795938 102025 KINDRED HOSPITAL THE PALM BEACHES 5555 W BLUE HERON BLVD RIVIERA BEACH FL 33418 PALM BEACH 5618400754 102026 FLORIDA HOSPITAL AT CONNERTON LONG TERM ACUTE 9441 HEALTH CENTER DR LAND O LAKES FL 34637 PASCO 8139716000 CARE 102027 KINDRED HOSPITAL MELBOURNE 765 W NASA BLVD MELBOURNE FL 32901 BREVARD 3217335725 102028 PROMISE HOSPITAL OF FLORIDA AT THE VILLAGES 5050 COUNTY ROAD 472 OXFORD FL 34484 SUMTER 5618693100 102029 PROMISE HOSPITAL OF FORT MYERS 3050 CHAMPION RING ROAD FORT MYERS FL 33905 LEE 7083634925 102030 SELECT SPECIALTY HOSPITAL DAYTONA BEACH 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH FL 32117 VOLUSIA 3862313907 102031 PROMISE HOSPITAL OF MIAMI 14001 NW 82ND AVENUE MIAMI LAKES FL 33016 MIAMI‐DADE 9545945525 102032 LANDMARK HOSPITAL OF SOUTHWEST FLORIDA 1285 CREEKSIDE BLVD E NAPLES FL 34108 COLLIER 2394788398 103026 ST CATHERINE'S REHABILITATION HOSPITAL 1050 NE 125TH ST NORTH MIAMI FL 33161 MIAMI‐DADE 3058918850 103027 ST ANTHONY'S REHABILITATION HOSPITAL 3487 NW 30TH ST LAUDERDALE LAKES FL 33311 BROWARD 9547396233 103028 HEALTHSOUTH SUNRISE REHABILITATION HOSPITAL 4399 NOB HILL RD SUNRISE FL 33351 BROWARD 9547490300 103031 HEALTHSOUTH REHABILITATION HOSPITAL OF SARASOTA 6400 EDGELAKE DR SARASOTA FL 34240 SARASOTA 9419218600
103032 HEALTHSOUTH TREASURE COAST REHABILITATION 1600 37TH ST VERO BEACH FL 32960 INDIAN RIVER 7727782100 HOSPITAL 103033 HEALTHSOUTH REHABILITATION HOSPITAL OF 1675 RIGGINS RD TALLAHASSEE FL 32308 LEON 8506564800 TALLAHASSEE
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 46 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 103034 HEALTHSOUTH SEA PINES REHABILITATION HOSPITAL 101 E FLORIDA AVENUE MELBOURNE FL 32901 BREVARD 3219844600 103036 WEST GABLES REHABILITATION HOSPITAL 2525 SW 75TH AVE MIAMI FL 33155 MIAMI‐DADE 3052601816 103037 HEALTHSOUTH REHABILITATION HOSPITAL OF LARGO 901 CLEARWATER LARGO RD N LARGO FL 34641 PINELLAS 7275862999
103038 HEALTHSOUTH REHABILITATION HOSPITAL OF MIAMI 20601 OLD CUTLER RD MIAMI FL 33189 MIAMI‐DADE 3052513800 103039 BROOKS REHABILITATION HOSPITAL 3599 UNIVERSITY BLVD S JACKSONVILLE FL 32216 9048587625 103040 HEALTHSOUTH EMERALD COAST REHABILITATION 1847 FLORIDA AVE PANAMA CITY FL 32403 BAY 8509148653 HOSPITAL 103042 HEALTHSOUTH REHABILITATION HOSPITAL OF SPRING HILL 12440 CORTEZ BLVD BROOKSVILLE FL 34613 HERNANDO 3525924250
103043 HEALTHSOUTH REHABILITATION HOSPITAL OF OCALA 2275 SW 22ND LANE OCALA FL 34471 MARION 3522824000 103044 HEALTHSOUTH REHABILITATION HOSPITAL AT MARTIN 5850 SE COMMUNITY DR STUART FL 34997 MARTIN 7723243522 HEAL 103045 HEALTHSOUTH REHABILITATION HOSPITAL OF ALTAMONTE 831 S STATE RD 434 ALTAMONTE FL 32714 SEMINOLE 4075878600 S 103300 ALL CHILDREN'S HOSPITAL, INC 501 SIXTH AVENUE SOUTH SAINT PETERSBURG FL 33701 PINELLAS 8138987451 103301 NICKLAUS CHILDREN'S HOSPITAL 3100 SW 62ND AVE MIAMI FL 33155 MIAMI‐DADE 3056666511 103303 SHRINERS HOSPITALS FOR CHILDREN‐TAMPA 12502 USF PINE DR TAMPA FL 33612 HILLSBOROUGH 8139722250 103304 NEMOURS CHILDREN'S HOSPITAL 13535 NEMOURS PKWY ORLANDO FL 32827 ORANGE 4075674000 104000 FLORIDA STATE HOSPITAL UNIT 14 PSYCH 100 N MAIN ST CHATTAHOOCHEE FL 32324 GADSDEN 8506637536 104001 SOUTH FLORIDA STATE HOSPITAL 800 E CYPRESS DR PEMBROKE PINES FL 33025 BROWARD 3059677000 104007 NORTHEAST FLORIDA STATE HOSPITAL 7487 S STATE RD 121 MACCLENNY FL 32063 BAKER 9042596211 104008 THE JEROME GOLDEN CENTER FOR BEHAVIORAL HEALTH, 1041 45TH ST WEST PALM BEACH FL 33407 PALM BEACH 5618449741 IN 104016 RIVER POINT BEHAVIORAL HEALTH 6300 BEACH BLVD JACKSONVILLE FL 32216 8003427552 104017 WINDMOOR HEALTHCARE OF CLEARWATER 11300 US 19 N CLEARWATER FL 33764 PINELLAS 7275412646 104018 LIFESTREAM BEHAVIORAL CENTER 2020 TALLY RD LEESBURG FL 34749 LAKE 3523606598 104024 CIRCLES OF CARE, INC 400 E SHERIDAN RD MELBOURNE FL 32901 BREVARD 3219844900 104026 FORT LAUDERDALE HOSPITAL 1601 E LAS OLAS BLVD FORT LAUDERDALE FL 33301 BROWARD 9544634321 104027 WEST FLORIDA COMMUNITY CARE CENTER 5500 STEWART ST MILTON FL 32570 SANTA ROSA 9046234990 104040 CENTERSTONE OF FLORIDA 2020 26TH AVE E BRADENTON FL 34208 MANATEE 9417413805 104049 SOUTHERN WINDS 4225 W 20TH AVE HIALEAH FL 33012 MIAMI‐DADE 3055589700 104057 SPRINGBROOK HOSPITAL 7007 GROVE RD BROOKSVILLE FL 34609 HERNANDO 3525964306
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 47 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 104059 EASTSIDE PSYCHIATRIC HOSPITAL 2634B CAPITAL CIRCLE NE, 2ND FLR TALLAHASSEE FL 32308 LEON 9044872930 104063 WILLOUGH AT NAPLES, THE 9001 TAMIAMI TRAIL EAST NAPLES FL 34113 COLLIER 9417754500 104065 ATLANTIC SHORES HOSPITAL 4545 N FEDERAL HWY FORT LAUDERDALE FL 33308 BROWARD 9547712711 104067 ASPIRE HEALTH PARTNERS 1800 MERCY DR ORLANDO FL 32808 ORANGE 4078753700 104068 CENTERS INC, THE 5664 SW 60TH AVE OCALA FL 34474 MARION 3522915555 104069 WEKIVA SPRINGS 3947 SALISBURY RD JACKSONVILLE FL 32216 9042963533 104070 PORT ST LUCIE HOSPITAL 2550 SE WALTON RD PORT SAINT LUCIE FL 34952 ST. LUCIE 7723350400 104071 VINES HOSPITAL 3130 SW 27TH AVE OCALA FL 34474 ALACHUA 3526713130 104072 CENTRAL FLORIDA BEHAVIORAL HOSPITAL 6601 CENTRAL FLORIDA PARKWAY ORLANDO FL 32821 ORANGE 4073700111 104073 EMERALD COAST BEHAVIORAL HOSPITAL 1940 HARRISON AVE PANAMA CITY FL 32405 BAY 8507630017 104074 PARK ROYAL HOSPITAL 9241 PARK ROYAL DR FORT MYERS FL 33908 LEE 2393320125 104075 NORTH TAMPA BEHAVIORAL HEALTH 29910 SR 56 WESLEY CHAPEL FL 33543 PASCO 8133330000 104076 UNIVERSITY BEHAVIORAL CENTER 2500 DISCOVERY DRIVE ORLANDO FL 32826 ORANGE 4072817000 104078 SUNCOAST BEHAVIORAL HEALTH CENTER 4480 51ST ST W BRADENTON FL 34210 MANATEE 9417922222 109801 TAMPA GENERAL HOSPITAL 1 TAMPA GENERAL CIR TAMPA FL 33601 HILLSBOROUGH 8138444602 109802 FLORIDA HOSPITAL 601 E ROLLINS STREET ORLANDO FL 32803 ORANGE 4073039659 109803 SHANDS HOSPITAL AT THE UNIVERSITY OF FLORIDA 1600 SW ARCHER RD GAINESVILLE FL 32610 ALACHUA 3522650111 109804 JACKSON MEMORIAL HOSPITAL 1611 NW 12TH AVENUE, WW117 MIAMI FL 33136 MIAMI‐DADE 3055856754 109805 BROWARD HEALTH BROWARD GENERAL MEDICAL CENTER 1600 SOUTH ANDREWS AVE FORT LAUDERDALE FL 33316 BROWARD 9543555610
109806 MAYO CLINIC 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 9049532000 109807 HALIFAX HEALTH MEDICAL CENTER 303 N CLYDE MORRIS BLVD DAYTONA BEACH FL 32114 VOLUSIA 3862544060 109808 JOHN HOPKINS ALL CHILDREN'S HOSPITAL 801 SIXTH ST S SAINT PETERSBURG FL 33701 PINELLAS 7277674474 109809 GULF COAST MEDICAL CENTER LEE MEM HEALTH SYSTEM 13681 DOCTOR'S WAY FORT MYERS FL 33912 LEE 2399391147
109810 MEMORIAL REGIONAL HOSPITAL 3501 JOHNSON ST HOLLYWOOD FL 33021 BROWARD 9542655814 109811 CLEVELAND CLINIC FLORIDA 2950 CLEVELAND CLINIC BLVD WESTON FL 33331 BROWARD 9546895000 109812 LARGO MEDICAL CENTER 1345 WEST BAY DRIVE, SUITE 301 LARGO FL 33770 PINELLAS 7275885872 110001 HAMILTON MEDICAL CENTER 1200 MEMORIAL DRIVE DALTON GA 30720 WHITFIELD 7062726105 110002 UPSON REGIONAL MEDICAL CENTER 801 W GORDON STREET THOMASTON GA 30286 UPSON 7066478111 110003 MAYO CLINIC HEALTH SYSTEM IN WAYCROSS, INC 1900 TEBEAU STREET WAYCROSS GA 31501 WARE 9122872500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 48 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 110004 CORNERSTONE MEDICAL CENTER 100 GROSS CRESCENT FORT OGLETHORPE GA 30742 CATOOSA 7068582101 110005 NORTHSIDE HOSPITAL FORSYTH 1200 NORTHSIDE FORSYTH DRIVE CUMMING GA 30041 FORSYTH 7708443200 110006 ST MARY'S HOSPITAL 1230 BAXTER STREET ATHENS GA 30606 7063893930 110007 PHOEBE PUTNEY MEMORIAL HOSPITAL 417 THIRD AVENUE ALBANY GA 31703 DOUGHERTY 2293124068 110008 NORTHSIDE HOSPITAL CHEROKEE 201 HOSPITAL ROAD CANTON GA 30114 CHEROKEE 7707205100 110010 EMORY UNIVERSITY HOSPITAL 1364 CLIFTON ROAD, NE ATLANTA GA 30322 DEKALB 4046868500 110011 TANNER MEDICAL CENTER ‐ CARROLLTON 705 DIXIE STREET CARROLLTON GA 30117 CARROLL 7708369580 110015 TANNER MEDICAL CENTER VILLA RICA 601 DALLAS HIGHWAY VILLA RICA GA 30180 CARROLL 7704563101 110016 WELLSTAR WEST GEORGIA MEDICAL CENTER 1514 VERNON ROAD LAGRANGE GA 30240 TROUP 7068821411 110018 PIEDMONT NEWTON HOSPITAL 5126 HOSPITAL DRIVE NE COVINGTON GA 30014 NEWTON 7707867053 110023 GORDON HOSPITAL 1035 RED BUD ROAD CALHOUN GA 30701 GORDON 7066292895 110024 CANDLER HOSPITAL 5353 REYNOLDS STREET SAVANNAH GA 31412 CHATHAM 9128196000 110025 SOUTHEAST GEORGIA HEALTH SYSTEM‐ BRUNSWICK 2415 PARKWOOD DRIVE BRUNSWICK GA 31520 GLYNN 9124667000 CAMPUS 110026 ELBERT MEMORIAL HOSPITAL 4 MEDICAL DRIVE ELBERTON GA 30635 ELBERT 7062132535 110027 ST MARY'S SACRED HEART HOSPITAL, INC 367 CLEAR CREEK PARKWAY LAVONIA GA 30553 FRANKLIN 7063567800 110028 UNIVERSITY HOSPITAL 1350 WALTON WAY AUGUSTA GA 30901 7067229011 110029 NORTHEAST GEORGIA MEDICAL CENTER, INC 743 SPRING STREET GAINESVILLE GA 30501 HALL 7705353553 110030 CARTERSVILLE MEDICAL CENTER 960 JOE FRANK HARRIS PARKWAY CARTERSVILLE GA 30120 BARTOW 7703878182 110031 WELLSTAR SPALDING REGIONAL HOSPITAL 601 SOUTH 8TH STREET GRIFFIN GA 30223 SPALDING 7702282721 110032 STEPHENS COUNTY HOSPITAL 163 HOSPITAL DRIVE TOCCOA GA 30577 STEPHENS 7062824250 110034 AU MEDICAL CENTER 1120 15TH STREET AUGUSTA GA 30912 7067216569 110035 WELLSTAR KENNESTONE HOSPITAL 677 CHURCH STREET MARIETTA GA 30060 COBB 7707935000 110036 MEMORIAL HEALTH UNIV MED CEN, INC 4700 WATERS AVENUE SAVANNAH GA 31403 CHATHAM 9123508000 110038 JOHN D ARCHBOLD MEMORIAL HOSPITAL 915 GORDON AVENUE & MIMOSA DRIVE THOMASVILLE GA 31792 THOMAS 2292282880 110039 TRINITY HOSPITAL OF AUGUSTA 2260 WRIGHTSBORO RD AUGUSTA GA 30904 7064817000 110040 NORTHRIDGE MEDICAL CENTER 70 MEDICAL CENTER DRIVE COMMERCE GA 30529 JACKSON 7063351100 110041 HABERSHAM COUNTY MEDICAL CTR 541 HISTORIC HIGHWAY 441‐NORTH DEMOREST GA 30535 HABERSHAM 7067542161 110042 WELLSTAR PAULDING HOSPITAL 2518 JIMMY LEE SMITH PARKWAY HIRAM GA 30141 PAULDING 4706447000 110043 ST JOSEPH'S HOSPITAL ‐ SAVANNAH 11705 MERCY BOULEVARD SAVANNAH GA 31419 CHATHAM 9128194100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 49 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 110044 PHOEBE SUMTER MEDICAL CENTER 126 HIGHWAY 280 W AMERICUS GA 31719 SUMTER 2299311280 110045 BARROW REGIONAL MEDICAL CENTER 316 NORTH BROAD STREET WINDER GA 30680 BARROW 7703075210 110046 CLEARVIEW REGIONAL MEDICAL CENTER 2151 WEST SPRING STREET MONROE GA 30655 WALTON 7702678461 110050 MURRAY MEDICAL CENTER 707 OLD DALTON ELLIJAY ROAD, PO BOX 1406 CHATSWORTH GA 30705 MURRAY 7065172031 110051 UNION GENERAL HOSPITAL 35 HOSPITAL ROAD BLAIRSVILLE GA 30512 UNION 7067452111 110054 FLOYD MEDICAL CENTER 304 TURNER MCCALL BLVD P O BOX 233 ROME GA 30162 FLOYD 7065096900 110064 MIDTOWN MEDICAL CENTER 710 CENTER ST BOX 951 COLUMBUS GA 31901 7065711000 110069 HOUSTON MEDICAL CENTER 1601 WATSON BOULEVARD WARNER ROBINS GA 31093 HOUSTON 4789224281 110071 APPLING HOSPITAL 163 E TOLLISON STREET BAXLEY GA 31513 APPLING 9123679841 110073 DORMINY MEDICAL CENTER 200 PERRY HOUSE ROAD, BOX 1447 FITZGERALD GA 31750 BEN HILL 2294247100 110074 ATHENS REGIONAL MEDICAL CENTER 1199 PRINCE AVENUE ATHENS GA 30606 7064757000 110075 EAST GEORGIA REGIONAL MEDICAL CENTER 1499 FAIR ROAD STATESBORO GA 30458 BULLOCH 9124861500 110076 DEKALB MEDICAL CENTER 2701 N DECATUR ROAD DECATUR GA 30033 DEKALB 4045011000 110078 EMORY UNIVERSITY HOSPITAL MIDTOWN 550 PEACHTREE ST NE ATLANTA GA 30308 FULTON 4046864411 110079 GRADY MEMORIAL HOSPITAL 80 JESSE HILL, JR DRIVE SE ATLANTA GA 30303 FULTON 4046164252 110082 SAINT JOSEPH'S HOSPITAL OF ATLANTA, INC 5665 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 FULTON 6788435720 110083 PIEDMONT HOSPITAL 1968 PEACHTREE RD NW ATLANTA GA 30309 FULTON 4046055000 110086 WASHINGTON COUNTY REGIONAL MEDICAL CENTER 610 SPARTA ROAD SANDERSVILLE GA 31082 WASHINGTON 4782402100 110087 GWINNETT MEDICAL CENTER 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30045 GWINNETT 6783121000 110089 COFFEE REGIONAL MEDICAL CENTER 1101 OCILLA ROAD DOUGLAS GA 31533 COFFEE 2293841900 110091 ROCKDALE MEDICAL CENTER 1412 MILSTEAD AVENUE, NE CONYERS GA 30012 ROCKDALE 7709183000 110092 DODGE COUNTY HOSPITAL 901 GRIFFIN AVE EASTMAN GA 31023 DODGE 4784484067 110095 TIFT REGIONAL MEDICAL CENTER 901 E 18TH STREET TIFTON GA 31793 TIFT 2293827120 110100 JEFFERSON HOSPITAL 1067 PEACHTREE ST LOUISVILLE GA 30434 JEFFERSON 4786257000 110101 COOK MEDICAL CENTER A CAMPUS OF TIFT REG MED CTR 706 N PARRISH AVE ADEL GA 31620 COOK 2298968077
110104 CRISP REGIONAL HOSPITAL 902 7TH STREET NORTH CORDELE GA 31015 CRISP 2292763100 110105 COLQUITT REGIONAL MEDICAL CENTER 3131 THOMASVILLE HWY BOX 40 MOULTRIE GA 31768 COLQUITT 2299853420 110107 MEDICAL CENTER, NAVICENT HEALTH (THE) 777 HEMLOCK STREET MACON GA 31201 BIBB 4786331000 110109 EMANUEL MEDICAL CENTER 117 KITE ROAD SWAINSBORO GA 30401 EMANUEL 4782891304
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 50 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 110111 UNIVERSITY HOSPITAL MCDUFFIE 2460 WASHINGTON ROAD THOMSON GA 30824 MCDUFFIE 7065951411 110113 BURKE MEDICAL CENTER 351 SOUTH LIBERTY STREET WAYNESBORO GA 30830 BURKE 7065544435 110115 WELLSTAR ATLANTA MEDICAL CENTER 303 PARKWAY DRIVE, NE ATLANTA GA 30312 FULTON 4042654000 110121 GRADY GENERAL HOSPITAL 1155 5TH STREET, SE CAIRO GA 39828 GRADY 2293770251 110122 SOUTH GEORGIA MEDICAL CENTER 2501 NORTH PATTERSON STREET, PO BOX 1727 VALDOSTA GA 31603 LOWNDES 2293331020 110124 WAYNE MEMORIAL HOSPITAL 865 SOUTH FIRST STREET JESUP GA 31545 WAYNE 9125303302 110125 FAIRVIEW PARK HOSPITAL 200 INDUSTRIAL BOULEVARD DUBLIN GA 31021 LAURENS 4782743100 110128 MEADOWS REGIONAL MEDICAL CENTER ONE MEADOWS PARKWAY VIDALIA GA 30474 TOOMBS 9125355828 110129 ST FRANCIS HOSPITAL 2122 MANCHESTER EXPRESSWAY COLUMBUS GA 31995 7065964020 110130 IRWIN COUNTY HOSPITAL 710 N IRWIN AVENUE OCILLA GA 31774 IRWIN 2294683845 110132 MEMORIAL HOSPITAL AND MANOR 1500 E SHOTWELL STREET BAINBRIDGE GA 39819 DECATUR 2292463500 110135 TAYLOR REGIONAL HOSPITAL 222 PERRY HWY HAWKINSVILLE GA 31036 PULASKI 4787830200 110142 EVANS MEMORIAL HOSPITAL 200 N RIVER STREET CLAXTON GA 30417 EVANS 9127395105 110143 WELLSTAR COBB HOSPITAL 3950 AUSTELL RD AUSTELL GA 30106 COBB 7707324000 110146 SOUTHEAST GEORGIA HEALTH SYSTEM‐ CAMDEN CAMPUS 2000 DAN PROCTOR DRIVE SAINT MARYS GA 31558 CAMDEN 9125766401
110150 OCONEE REGIONAL MEDICAL CENTER 821 N COBB STREET POST OFFICE BOX 690 MILLEDGEVILLE GA 31061 BALDWIN 4784543550 110153 PERRY HOSPITAL 1120 MORNINGSIDE DR PERRY GA 31069 HOUSTON 4789873600 110161 NORTHSIDE HOSPITAL 1000 JOHNSON FERRY ROAD, NE ATLANTA GA 30342 FULTON 4048518000 110164 COLISEUM MEDICAL CENTERS 350 HOSPITAL DRIVE MACON GA 31217 BIBB 4787657000 110165 SOUTHERN REGIONAL MEDICAL CENTER 11 UPPER RIVERDALE ROAD, SW RIVERDALE GA 30274 CLAYTON 7709918160 110168 REDMOND REGIONAL MEDICAL CENTER 501 REDMOND ROAD ROME GA 30165 FLOYD 7068023012 110177 DOCTORS HOSPITAL 3651 WHEELER ROAD AUGUSTA GA 30909 7066516008 110183 EMORY‐ADVENTIST HOSPITAL 3949 SOUTH COBB DRIVE SMYRNA GA 30080 COBB 7704340710 110184 WELLSTAR DOUGLAS HOSPITAL 8954 HOSPITAL DRIVE DOUGLASVILLE GA 30134 DOUGLAS 7709491500 110187 CHESTATEE REGIONAL HOSPITAL 227 MOUNTAIN DR DAHLONEGA GA 30533 LUMPKIN 7068646136 110189 FANNIN REGIONAL HOSPITAL 2855 OLD HIGHWAY 5 NORTH BLUE RIDGE GA 30513 FANNIN 7066323711 110190 FLINT RIVER COMMUNITY HOSPITAL 509 SUMTER STREET, BOX 770 MONTEZUMA GA 31063 MACON 4784723100 110191 PIEDMONT HENRY HOSPITAL 1133 EAGLE'S LANDING PARKWAY STOCKBRIDGE GA 30281 HENRY 6786041000 110192 EASTSIDE MEDICAL CENTER 1700 MEDICAL WAY SNELLVILLE GA 30078 GWINNETT 7707362498
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 51 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 110194 DONALSONVILLE HOSPITAL INC 102 HOSPITAL CIR DONALSONVILLE GA 39845 SEMINOLE 2295245217 110198 WELLSTAR NORTH FULTON HOSPITAL 3000 HOSPITAL BOULEVARD ROSWELL GA 30076 FULTON 7707512500 110200 NORTHSIDE MEDICAL CENTER 100 FRIST COURT COLUMBUS GA 31909 7064942100 110201 COLISEUM NORTHSIDE HOSPITAL 400 CHARTER BOULEVARD MACON GA 31210 BIBB 4787578200 110205 NORTH GEORGIA MEDICAL CENTER 1362 SOUTH MAIN STREET ELLIJAY GA 30540 GILMER 7062764741 110209 TURNING POINT HOSPITAL 3015 VETERANS PARKWAY MOULTRIE GA 31788 COLQUITT 2299854815 110215 PIEDMONT FAYETTE HOSPITAL 1255 HIGHWAY 54 WEST FAYETTEVILLE GA 30214 FAYETTE 7707197071 110225 PIEDMONT MOUNTAINSIDE HOSPITAL INC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 PICKENS 7063015269 110226 DEKALB MEDICAL CENTER AT HILLANDALE 2801 DEKALB MEDICAL PARKWAY LITHONIA GA 30058 DEKALB 4045018040 110229 PIEDMONT NEWNAN HOSPITAL, INC 745 POPLAR ROAD NEWNAN GA 30265 COWETA 7704002300 110230 EMORY JOHNS CREEK HOSPITAL 6325 HOSPITAL PARKWAY JOHNS CREEK GA 30097 CHATTOOGA 6784747000 110233 SOUTHEASTERN REGIONAL MEDICAL CENTER 600 CELEBRATE LIFE PARKWAY NEWNAN GA 30265 COWETA 4048448334 110234 SGMC BERRIEN CAMPUS 1221 E MCPHERSON AVENUE NASHVILLE GA 31639 BERRIEN 2295437100 110235 LANDMARK HOSPITAL OF SAVANNAH 800 E 68TH STREET SAVANNAH GA 31405 CHATHAM 5733318420 11028F US PENITENTIARY HOSP 601 MCDONOUGH BLVD SE ATLANTA GA 30315 FULTON 4046355100 11029F ATLANTA VA MEDICAL CENTER 1670 CLAIRMONT RD NE DECATUR GA 30033 DEKALB 4043216111 11030F AUGUSTA VA MEDICAL CENTER 1 FREEDOM WAY AUGUSTA GA 30904 7067330188 11031F CARL VINSON VA MEDICAL CENTER 1826 VETERANS BLVD DUBLIN GA 31021 LAURENS 4782721210 11032F US ARMY HOSP 9200 MARNE RD FORT BENNING GA 31905 7065443534 11033F US ARMY HOSP 33513 KILBOURNE ST AUGUSTA GA 30905 7067877300 11034F US ARMY HOSP FORT MCPHERSON FORT MCPHERSON GA 30330 FULTON 4044640418 11035F US ARMY HOSP 1061 HARMON AVENUE FORT STEWART GA 31314 LIBERTY 9124356965 11038F US AIR FORCE HOSP 3278 MITCHELL BLVD, BLD 900 VALDOSTA GA 31601 LOWNDES 2292572778 11039F US AIR FORCE HOSP 655 SEVENTH STREET ROBINS AFB GA 31098 HOUSTON 4783277850 111300 SOUTHWEST GEORGIA REGIONAL MEDICAL CENTER 361 RANDOLPH STREET CUTHBERT GA 39840 RANDOLPH 2297322181 111302 BLECKLEY MEMORIAL HOSPITAL 145 EAST PEACOCK STREET COCHRAN GA 31014 BLECKLEY 4789346211 111303 JASPER MEMORIAL HOSPITAL 898 COLLEGE STREET MONTICELLO GA 31064 JASPER 7064686411 111304 MORGAN MEMORIAL HOSPITAL 1077 SOUTH MAIN STREET MADISON GA 30650 MORGAN 7063421667 111305 MILLER COUNTY HOSPITAL 209 N CUTHBERT STREET COLQUITT GA 39837 MILLER 2297584231 111306 EFFINGHAM HOSPITAL 459 GA HIGHWAY 119 SOUTH SPRINGFIELD GA 31329 EFFINGHAM 9127540160
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 52 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 111308 CLINCH MEMORIAL HOSPITAL 1050 VALDOSTA HIGHWAY HOMERVILLE GA 31634 CLINCH 9124875211 111310 MEDICAL CENTER OF PEACH COUNTY, NAVICENT HEALTH 1960 HIGHWAY 247 CONNECTOR BYRON GA 31008 PEACH 4786542000
111311 OPTIM MEDICAL CENTER ‐ JENKINS 931 EAST WINTHROPE AVENUE MILLEN GA 30442 JENKINS 4784784221 111312 OPTIM MEDICAL CENTER ‐ SCREVEN 215 MIMS ROAD SYLVANIA GA 30467 SCREVEN 9125647426 111313 PUTNAM GENERAL HOSPITAL 101 LAKE OCONEE PARKWAY EATONTON GA 31024 PUTNAM 7064852711 111314 PIONEER COMMUNITY HOSPITAL OF EARLY 11740 COLUMBIA STREET BLAKELY GA 39823 EARLY 2297234241 111316 WARM SPRINGS MEDICAL CENTER 5995 SPRING STREET WARM SPRINGS GA 31830 MERIWETHER 7066559351 111318 MONROE COUNTY HOSPITAL 88 MARTIN LUTHER KING JR DRIVE FORSYTH GA 31029 MONROE 4789942521 111319 WELLSTAR SYLVAN GROVE HOSPITAL 1050 MCDONOUGH ROAD JACKSON GA 30233 BUTTS 7707757861 111320 HIGGINS GENERAL HOSPITAL 200 ALLEN MEMORIAL DRIVE BREMEN GA 30110 HARALSON 7708242210 111323 OPTIM MEDICAL CENTER ‐ TATTNALL 247 S MAIN STREET REIDSVILLE GA 30453 TATTNALL 9125571000 111324 CHATUGE REGIONAL HOSPITAL 110 EAST MAIN STREET HIAWASSEE GA 30546 TOWNS 7068962222 111325 WILLS MEMORIAL HOSPITAL 120 GORDON STREET WASHINGTON GA 30673 WILKES 7066789212 111326 SGMC LANIER CAMPUS 116 WEST THIGPEN AVENUE LAKELAND GA 31635 LANIER 2294828402 111327 BACON COUNTY HOSPITAL 302 SOUTH WAYNE STREET ALMA GA 31510 BACON 9126328961 111328 PHOEBE WORTH MEDICAL CENTER 807 SOUTH ISABELLA STREET SYLVESTER GA 31791 WORTH 2297773851 111329 ST MARY'S GOOD SAMARITAN HOSPITAL 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 GREENE 7064537331 111330 POLK MEDICAL CENTER 2360 ROCKMART HIGHWAY CEDARTOWN GA 30125 POLK 7707482500 111331 MITCHELL COUNTY HOSPITAL 90 STEPHENS STREET CAMILLA GA 31730 MITCHELL 2293365284 111332 BROOKS COUNTY HOSPITAL 903 N COURT ST QUITMAN GA 31643 BROOKS 9122636309 111333 JEFF DAVIS HOSPITAL 163 SOUTH TALLAHASSEE STREET, P O BOX 1690 HAZLEHURST GA 31539 JEFF DAVIS 9123757781 111334 CANDLER COUNTY HOSPITAL 400 CEDAR STREET METTER GA 30439 CANDLER 9126855741 111335 LIBERTY REGIONAL MEDICAL CENTER 462 E G MILES PARKWAY HINESVILLE GA 31310 LIBERTY 9123699438 111336 MOUNTAIN LAKES MEDICAL CENTER 196 RIDGECREST CIRCLE CLAYTON GA 30525 RABUN 7067820400 112000 ROOSEVELT WARM SPRINGS LTAC HOSPITAL 6135 ROOSEVELT HIGHWAY WARM SPRINGS GA 31830 MERIWETHER 7066555515 112003 SHEPHERD CENTER 2020 PEACHTREE RD NW ATLANTA GA 30309 FULTON 4043527311 112004 SELECT SPECIALTY HOSPITAL ‐ MIDTOWN ATLANTA, LLC 705 JUNIPER STREET, NE ATLANTA GA 30308 FULTON 4048732871
112005 SELECT SPECIALTY HOSPITAL ‐ NORTHEAST ATLANTA 1821 CLIFTON ROAD NE ATLANTA GA 30329 DEKALB 4047286200 112006 DEKALB MEDICAL CENTER AT DECATUR 450 NORTH CANDLER STREET DECATUR GA 30030 DEKALB 4043770221
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 53 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 112007 WELLSTAR WINDY HILL HOSPITAL 2540 WINDY HILL ROAD MARIETTA GA 30067 COBB 7706441081 112009 SELECT SPECIALTY HOSPITAL ‐ ATLANTA 550 PEACHTREE STREET NE, 7TH FLOOR ATLANTA GA 30308 FULTON 4046862270 112010 KINDRED HOSPITAL ROME 320 TURNER MCCALL BOULEVARD ROME GA 30165 FLOYD 7065094100 112011 SELECT SPECIALTY HOSPITAL ‐ SAVANNAH, INC 5353 REYNOLDS STREET 4 SOUTH SAVANNAH GA 31405 CHATHAM 9128197986 112012 COLUMBUS SPECIALTY HOSPITAL INC 616 19TH STREEET COLUMBUS GA 31901 7064944075 112013 SELECT SPECIALTY HOSPITAL ‐ AUGUSTA, INC 1537 WALTON WAY AUGUSTA GA 30904 7067311200 112014 REGENCY HOSPITAL OF SOUTH ATLANTA 1170 CLEVELAND AVE 4TH FLOOR EAST POINT GA 30344 FULTON 4044666264 112015 SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE 11 UPPER RIVERDALE ROAD SW 6TH FLOOR RIVERDALE GA 30274 CLAYTON 7708977600
112016 REGENCY HOSPITAL COMPANY OF MACON, LLC 535 COLISEUM DRIVE MACON GA 31217 BIBB 4788037300 112017 LANDMARK HOSPITAL OF ATHENS, LLC 775 SUNSET DRIVE ATHENS GA 30606 7064251518 112018 LANDMARK HOSPITAL OF SAVANNAH, LLC 800 E 68TH STREET SAVANNAH GA 31405 CHATHAM 5733318420 113028 ROOSEVELT WARM SPRINGS REHABILITATION HOSPITAL 6135 ROOSEVELT HIGHWAY WARM SPRINGS GA 31830 MERIWETHER 7066555515
113029 REHABILITATION HOSPITAL, NAVICENT HEALTH 3351 NORTHSIDE DRIVE MACON GA 31210 BIBB 4784716500 113030 HEALTHSOUTH WALTON REHABILITATION HOSPITAL 1355 INDEPENDENCE DRIVE AUGUSTA GA 30901 7067247746 113031 EMORY REHABILITATION HOSPITAL 1441 CLIFTON ROAD ATLANTA GA 30322 DEKALB 4047125512 113032 HEALTHSOUTH REHABILITATION HOSPITAL OF NEWNAN 2101 EAST NEWNAN CROSSING BLVD NEWNAN GA 30265 COWETA 6785526200
113033 REHABILITATION HOSPITAL OF SAVANNAH 6510 SEAWRIGHT DRIVE SAVANNAH GA 31404 CHATHAM 9122356000 113300 CHILDREN'S HEALTHCARE OF ATLANTA AT EGLESTON 1405 CLIFTON ROAD, NE ATLANTA GA 30322 DEKALB 4047856101 113301 CHILDRENS HEALTHCARE OF ATLANTA AT SCOTTISH RITE 1001 JOHNSON FERRY RD ATLANTA GA 30342 FULTON 4047855252
114004 SUMMITRIDGE CENTER‐ PSYCHIATRY & ADDICTIVE MED 250 SCENIC HIGHWAY LAWRENCEVILLE GA 30046 GWINNETT 6784425800
114008 COASTAL HARBOR TREATMENT CENTER 1150 CORNELL AVE SAVANNAH GA 31406 CHATHAM 9123543911 114010 PEACHFORD BEHAVIORAL HEALTH SYSTEM OF ATLANTA 2151 PEACHFORD ROAD ATLANTA GA 30338 DEKALB 7704553200
114012 RIDGEVIEW INSTITUTE 3995 S COBB DRIVE SMYRNA GA 30080 COBB 7704344567 114013 WEST CENTRAL GEORGIA REGIONAL HOSPITAL 3000 SCHATULGA RD BOX 12435 COLUMBUS GA 31917 7065685203 114016 ST SIMONS‐BY‐THE‐SEA 2927 DEMERE ROAD SAINT SIMONS ISLAND GA 31522 GLYNN 9126381999 114019 GEORGIA REGIONAL HOSPITAL ATLANTA 3073 PANTHERSVILLE ROAD DECATUR GA 30034 DEKALB 4042432100 114028 GEORGIA REGIONAL HOSP SAVANNAH 1915 EISENHOWER DR SAVANNAH GA 31416 CHATHAM 9123562045
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 54 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 114029 EAST CENTRAL REGIONAL HOSPITAL 3405 MIKE PADGETT HWY AUGUSTA GA 30906 7067927006 114032 SO CRESCENT BEH HLTH SYS ‐ ANCHOR HOSPITAL CAMPUS 5454 YORKTOWNE DRIVE COLLEGE PARK GA 30349 CLAYTON 7709916044
114035 RIVERWOODS BEHAVIORAL HEALTH SYSTEM 223 MEDICAL CENTER DRIVE RIVERDALE GA 30274 CLAYTON 7709918500 114036 GREENLEAF CENTER 2209 PINEVIEW DRIVE VALDOSTA GA 31602 LOWNDES 2292474357 119800 EMORY UNIVERSITY HOSPITAL 1364 CLIFTON ROAD, NE ATLANTA GA 30322 DEKALB 4046868500 119801 MEDICAL COLLEGE OF GEORGIA‐ TRANSPLANT 1120 FIFTEENTH ST AUGUSTA GA 30912 7067214716 119802 CHILDREN'S HEALTHCARE OF ATLANTA 1405 CLIFTON ROAD NE , 6TH FLOOR, TRANSPLANT SERVI ATLANTA GA 30322 DEKALB 4047856121
119803 PIEDMONT HOSPITAL 1968 PEACHTREE ROAD NW ATLANTA GA 30309 FULTON 4046053775 120001 THE QUEENS MEDICAL CENTER 1301 PUNCHBOWL ST HONOLULU HI 96813 HONOLULU 8085389011 120002 MAUI MEMORIAL MEDICAL CENTER 221 MAHALANI STREET WAILUKU HI 96793 MAUI 8084425101 120004 WAHIAWA GENERAL HOSPITAL 128 LEHUA STREET WAHIAWA HI 96786 HONOLULU 8086218411 120005 HILO MEDICAL CENTER 1190 WAIANUENUE AVENUE HILO HI 96720 HAWAII 8089323000 120006 CASTLE MEDICAL CENTER 640 ULUKAHIKI ST KAILUA HI 96734 HONOLULU 8082635500 120007 KUAKINI MEDICAL CENTER 347 NORTH KUAKINI STREET HONOLULU HI 96817 HONOLULU 8085362236 120011 KAISER FOUNDATION HOSPITAL 3288 MOANALUA RD HONOLULU HI 96819 HONOLULU 8084320000 120014 WILCOX MEMORIAL HOSPITAL 3‐3420 KUHIO HIGHWAY LIHUE HI 96766 KAUAI 8082451103 120019 KONA COMMUNITY HOSPITAL 79‐1019 HAUKAPILA STREET KEALAKEKUA HI 96750 HAWAII 8083229311 12001F US ARMY TRIPLER GEN HOSP APO TAMC HI 96438 120022 STRAUB CLINIC AND HOSPITAL 888 SO KING STREET HONOLULU HI 96813 HONOLULU 8085224000 120026 PALI MOMI MEDICAL CENTER 98‐1079 MOANALUA ROAD AIEA HI 96701 HONOLULU 8084866000 120028 NORTH HAWAII COMMUNITY HOSPITAL 67 1125 MAMALAHOA HIGHWAY KAMUELA HI 96743 HAWAII 8088854444 12002E WAIMANO TRAINING SCHOOL & HOSP PEARL CITY HI 96782 HONOLULU 12003E HALE MOHALU HOSP PEARL CITY HI 96782 HONOLULU 12005E KALAUPAPA SETTLEMENT HOSP MOLOKAI HI 96742 MAUI 12006F VA PACIFIC ISLANDS HCS 459 PATTERSON ROAD HONOLULU HI 96819 HONOLULU 8084330464 121300 KAUAI VETERANS MEMORIAL HOSPITAL 4643 WAIMEA CANYON DRIVE WAIMEA HI 96796 KAUAI 8083389431 121301 KAU HOSPITAL 1 KAMANI STREET PAHALA HI 96777 HAWAII 8089288331 121302 KOHALA HOSPITAL 54‐383 HOSPITAL ROAD KAPAAU HI 96755 HAWAII 8088896211 121303 MOLOKAI GENERAL HOSPITAL 280 HOME OLU PLACE KAUNAKAKAI HI 96748 MAUI 8085535331
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 55 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 121304 KAHUKU MEDICAL CENTER 56‐117 PUALALEA STREET KAHUKU HI 96731 HONOLULU 8082939221 121305 LANAI COMMUNITY HOSPITAL 628 7TH STREET LANAI CITY HI 96763 MAUI 8085658450 121306 SAMUEL MAHELONA MEMORIAL HOSPITAL 4800 KAWAIHAU ROAD KAPAA HI 96746 KAUAI 8088224961 121307 HALE HO'OLA HAMAKUA 45‐547 PLUMERIA STREET HONOKAA HI 96727 HAWAII 8089324100 121308 KULA HOSPITAL 100 KOKEA PLACE KULA HI 96790 MAUI 8088781221 122001 LEAHI HOSPITAL 3675 KILAUEA AVENUE HONOLULU HI 96816 HONOLULU 8087338000 123025 REHABILITATION HOSPITAL OF THE PACIFIC 226 N KUAKINI STREET HONOLULU HI 96817 HONOLULU 8085313511 123300 KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN 1319 PUNAHOU STREET HONOLULU HI 96826 HONOLULU 8089836000
123301 SHRINERS HOSPITAL FOR CHILDREN 1310 PUNAHOU STREET HONOLULU HI 96826 HONOLULU 8089414466 124001 KAHI MOHALA 91‐2301 FORT WEAVER ROAD EWA BEACH HI 96706 HONOLULU 8086718511 129801 THE QUEEN'S MEDICAL CENTER 1301 PUNCHBOWL STREET HON HI 96813 HONOLULU 8086917066 130002 ST LUKE'S MAGIC VALLEY RMC 801 POLE LINE ROAD WEST TWIN FALLS ID 83301 TWIN FALLS 2088141000 130003 ST JOSEPH REGIONAL MEDICAL CENTER 415 SIXTH STREET LEWISTON ID 83501 NEZ PERCE 2087995300 130006 ST LUKE'S REGIONAL MEDICAL CENTER 190 EAST BANNOCK STREET BOISE ID 83712 ADA 2083812222 130007 ST ALPHONSUS REGIONAL MEDICAL CENTER 1055 NORTH CURTIS ROAD BOISE ID 83706 ADA 2083672121 130013 SAINT ALPHONSUS MEDICAL CENTER ‐ NAMPA 1512 TWELFTH AVENUE ROAD NAMPA ID 83686 CANYON 2084635000 130014 WEST VALLEY MEDICAL CENTER 1717 ARLINGTON STREET CALDWELL ID 83605 CANYON 2084594641 130018 EASTERN IDAHO REGIONAL MEDICAL CENTER 3100 CHANNING WAY IDAHO FALLS ID 83404 BONNEVILLE 2085296111 130025 MADISON MEMORIAL HOSPITAL 450 EAST MAIN STREET REXBURG ID 83440 MADISON 2083596900 130028 PORTNEUF MEDICAL CENTER 777 HOSPITAL WAY POCATELLO ID 83201 BANNOCK 2082391452 13002F US AIR FORCE HOSP MOUNTAIN HOME AFB MOUNTAIN HOME ID 83648 ELMORE 13003F BOISE VA MEDICAL CENTER 500 W FORT ST BOISE ID 83702 ADA 2084221000 130049 KOOTENAI HEALTH 2003 KOOTENAI HEALTH WAY COEUR D'ALENE ID 83814 KOOTENAI 2086254000 130063 TREASURE VALLEY HOSPITAL 8800 WEST EMERALD STREET BOISE ID 83704 ADA 2083735000 130065 MOUNTAIN VIEW HOSPITAL 2325 CORONADO STREET IDAHO FALLS ID 83404 BONNEVILLE 2085572700 130066 NORTHWEST SPECIALTY HOSPITAL 1593 EAST POLSTON AVENUE POST FALLS ID 83854 KOOTENAI 2082622300 130067 IDAHO DOCTORS HOSPITAL 350 N MERIDIAN STREET BLACKFOOT ID 83221 BINGHAM 2087822900 131301 BOUNDARY COMMUNITY HOSPITAL 6640 KANIKSU STREET BONNERS FERRY ID 83805 BOUNDARY 2082674850 131302 NORTH CANYON MEDICAL CENTER 267 NORTH CANYON DR GOODING ID 83330 GOODING 2089344433
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 56 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 131303 NELL J REDFIELD MEMORIAL HOSPITAL 150 NORTH 200 WEST MALAD ID 83252 ONEIDA 2087662231 131304 HARMS MEMORIAL HOSPITAL 510 ROOSEVELT STREET AMERICAN FALLS ID 83211 POWER 2082263200 131305 STEELE MEMORIAL MEDICAL CENTER 203 SOUTH DAISY STREET SALMON ID 83467 LEMHI 2087565612 131307 WEISER MEMORIAL HOSPITAL 645 EAST 5TH STREET WEISER ID 83672 WASHINGTON 2085490370 131308 CASCADE MEDICAL CENTER 402 LAKE CASCADE PARKWAY CASCADE ID 83611 VALLEY 2083824242 131309 CARIBOU MEMORIAL HOSPITAL 300 SOUTH 3RD WEST SODA SPRINGS ID 83276 CARIBOU 2085473341 131310 ST LUKE'S JEROME 709 NORTH LINCOLN AVENUE JEROME ID 83338 JEROME 2088149500 131311 ST LUKE'S ELMORE MEDICAL CENTER 895 NORTH 6TH EAST MOUNTAIN HOME ID 83647 ELMORE 2085878401 131312 ST LUKE'S MCCALL 1000 STATE STREET MC CALL ID 83638 VALLEY 2086342221 131313 TETON VALLEY HOSPITAL 120 EAST HOWARD AVE DRIGGS ID 83422 TETON 2083542383 131314 SHOSHONE MEDICAL CENTER 25 JACOBS GULCH ROAD KELLOGG ID 83837 SHOSHONE 2087841221 131315 SYRINGA GENERAL HOSPITAL 607 W MAIN STREET GRANGEVILLE ID 83530 IDAHO 2089831700 131316 BEAR LAKE MEMORIAL HOSPITAL 164 SOUTH FIFTH STREET MONTPELIER ID 83254 BEAR LAKE 2088471630 131317 BENEWAH COMMUNITY HOSPITAL 229 SOUTH 7TH STREET ST MARIES ID 83861 BENEWAH 2082457614 131318 VALOR HEALTH 1202 EAST LOCUST STREET EMMETT ID 83617 GEM 2083653561 131319 MINIDOKA MEMORIAL HOSPITAL 1224 8TH STREET RUPERT ID 83350 MINIDOKA 2084360481 131320 CLEARWATER VALLEY HOSPITAL & CLINICS 301 CEDAR STREET OROFINO ID 83544 CLEARWATER 2084764555 131321 ST MARY'S HOSPITAL 701 LEWISTON ST COTTONWOOD ID 83522 IDAHO 2089623251 131322 FRANKLIN COUNTY MEDICAL CENTER 44 NORTH FIRST EAST PRESTON ID 83263 FRANKLIN 2088520137 131323 ST LUKE'S WOOD RIVER MEDICAL CENTER 100 HOSPITAL DRIVE KETCHUM ID 83340 BLAINE 2087278800 131324 LOST RIVERS HOSPITAL 551 HIGHLAND DRIVE ARCO ID 83213 BUTTE 2085278206 131325 BINGHAM MEMORIAL HOSPITAL 98 POPLAR STREET BLACKFOOT ID 83221 BINGHAM 2087853804 131326 CASSIA REGIONAL MEDICAL CENTER 1501 HILAND AVENUE BURLEY ID 83318 CASSIA 2086784444 131327 GRITMAN MEDICAL CENTER 700 SOUTH MAIN STREET MOSCOW ID 83843 LATAH 2088824511 131328 BONNER GENERAL HOSPITAL 520 NORTH THIRD AVENUE SANDPOINT ID 83864 BONNER 2082631441 132001 NORTHERN IDAHO ADVANCED CARE HOSPITAL 600 NORTH CECIL ROAD POST FALLS ID 83854 KOOTENAI 2082622800 132002 VIBRA HOSPITAL OF BOISE 2131 SOUTH BONITO WAY MERIDIAN ID 83642 ADA 2084899500 132003 SOUTHWEST IDAHO ADVANCED CARE HOSPITAL 6651 WEST FRANKLIN ROAD BOISE ID 83709 ADA 2086852400 133027 REHABILITATION HOSPITAL OF THE NORTHWEST 3372 E JENALAN AVE POST FALLS ID 83854 KOOTENAI 2082628700 134002 INTERMOUNTAIN HOSPITAL 303 NORTH ALLUMBAUGH STREET BOISE ID 83704 ADA 2083778400
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 57 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 134009 SAFE HAVEN HOSPITAL OF TREASURE VALLEY 8050 WEST NORTHVIEW STREET BOISE ID 83704 ADA 2083270504 134010 STATE HOSPITAL SOUTH 700 EAST ALICE STREET BLACKFOOT ID 83221 BINGHAM 2087851200 140001 GRAHAM HOSPITAL ASSOCIATION 210 WEST WALNUT STREET CANTON IL 61520 FULTON 3096475240 140002 ALTON MEMORIAL HOSPITAL ONE MEMORIAL DRIVE ALTON IL 62002 MADISON 6184637300 140007 PRESENCE SAINT JOSEPH MEDICAL CENTER 333 N MADISON JOLIET IL 60435 WILL 8157257133 140008 LOYOLA GOTTLIEB MEMORIAL HOSPITAL 701 WEST NORTH AVE MELROSE PARK IL 60160 COOK 7084504924 140010 EVANSTON HOSPITAL 2650 RIDGE AVE EVANSTON IL 60201 COOK 8474328000 140011 HERRIN HOSPITAL 201 S 14TH ST HERRIN IL 62948 WILLIAMSON 6189422171 140012 KATHERINE SHAW BETHEA HOSPITAL 403 E 1ST ST DIXON IL 61021 LEE 8152885531 140013 PROCTOR HOSPITAL 5409 N KNOXVILLE AVE PEORIA IL 61614 PEORIA 3096911000 140015 BLESSING HOSPITAL BROADWAY AT 11TH STREET QUINCY IL 62301 ADAMS 2172235811 140018 MT SINAI HOSPITAL MEDICAL CENTER 15TH STREET AT CALIFORNIA CHICAGO IL 60608 COOK 7732576751 140019 SHELBY MEMORIAL HOSPITAL 200 S CEDAR ST SHELBYVILLE IL 62565 SHELBY 2177743961 14001E DECATUR‐MACON CO TB SANATORIUM 400 W HAY ST DECATUR IL 62526 MACON 140029 COPLEY MEMORIAL HOSPITAL 2000 OGDEN AVENUE AURORA IL 60504 KANE 6309786200 14002F VA CHICAGO HEALTH CARE SYSTEM‐LAKESIDE DIVISION 333 EAST HURON STREET CHICAGO IL 60611 COOK 3125698387
140030 SHERMAN HOSPITAL 1425 NORTH RANDALL ROAD ELGIN IL 60123 KANE 8477429800 140032 ST ANTHONYS MEMORIAL HOSPITAL 503 N MAPLE STREET EFFINGHAM IL 62401 EFFINGHAM 2173422121 140033 VISTA MEDICAL CENTER WEST 2615 WASHINGTON ST WAUKEGAN IL 60085 LAKE 8472493900 140034 SSM HEALTH ST MARY'S HOSPITAL ‐CENTRALIA 400 NORTH PLEASANT AVENUE CENTRALIA IL 62801 MARION 6184366519 14003F VA CHICAGO HEALTH CARE SYSTEM‐WEST SIDE DIVISION 820 SOUTH DAMEN AVENUE CHICAGO IL 60612 COOK 3125698387
140040 GALESBURG COTTAGE HOSPITAL 695 N KELLOGG ST GALESBURG IL 61401 KNOX 3093454555 140043 CGH MEDICAL CENTER 100 EAST LEFEVRE ROAD STERLING IL 61081 WHITESIDE 8156250400 140046 GOOD SAMARITAN REGIONAL HLTH CENTER 1 GOOD SAMARITAN WAY MOUNT VERNON IL 62864 JEFFERSON 6188991469 140048 ADVOCATE TRINITY HOSPITAL 2320 E 93RD ST CHICAGO IL 60617 COOK 7739672000 140049 WEST SUBURBAN MEDICAL CENTER 3 ERIE COURT OAK PARK IL 60302 COOK 7083836200 14004F VA ILLIANA HEALTH CARE SYSTEM 1900 E MAIN ST DANVILLE IL 61832 VERMILION 2175543000 140052 OSF SAINT ANTHONY'S HEALTH CENTER ST ANTHONY'S WAY ALTON IL 62002 MADISON 6184652571 140053 ST JOHNS HOSPITAL 800 E CARPENTER ST SPRINGFIELD IL 62769 SANGAMON 2175446464
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 58 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 140054 MACNEAL HOSPITAL 3249 SOUTH OAK PARK AVENUE BERWYN IL 60402 COOK 7087839100 140058 PASSAVANT AREA HOSPITAL 1600 W WALNUT ST JACKSONVILLE IL 62650 MORGAN 2172459551 140059 JERSEY COMMUNITY HOSPITAL 400 MAPLE SUMMIT ROAD JERSEYVILLE IL 62052 JERSEY 6184986402 14005F VA HOSP DOWNEY IL 60064 LAKE 140062 PALOS COMMUNITY HOSPITAL 12251 SOUTH 80TH AVENUE PALOS HEIGHTS IL 60463 COOK 7089234000 140063 RUSH OAK PARK HOSPITAL 520 S MAPLE AVE OAK PARK IL 60304 COOK 7083839300 140064 ST MARY MEDICAL CENTER 3333 NORTH SEMINARY GALESBURG IL 61401 KNOX 3093443161 140065 ADVENTIST LA GRANGE MEMORIAL HOSPITAL 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525 COOK 7083521200 140067 SAINT FRANCIS MEDICAL CENTER 530 NE GLEN OAK AVE PEORIA IL 61637 PEORIA 3096552000 140068 ROSELAND COMMUNITY HOSPITAL 45 W 111TH STREET CHICAGO IL 60628 COOK 7739953000 14006F US NAVAL HOSP GREAT LAKES IL 60088 LAKE 140077 TOUCHETTE REGIONAL HOSPITAL INC 5900 BOND AVENUE CENTREVILLE IL 62207 ST. CLAIR 6183323060 14007F EDWARD HINES JR VA HOSPITAL 5TH AVE + ROOSEVELT RD, PO BOX 5000 HINES IL 60141 COOK 7082028387 140080 PRESENCE SAINT FRANCIS HOSPITAL 355 RIDGE AVE EVANSTON IL 60202 COOK 8473164000 140082 LOUIS A WEISS MEMORIAL HOSPITAL 4646 N MARINE DRIVE CHICAGO IL 60640 COOK 7738788700 140083 LORETTO HOSPITAL 645 SOUTH CENTRAL AVE CHICAGO IL 60644 COOK 7736264300 140084 VISTA MEDICAL CENTER EAST 1324 NORTH SHERIDAN ROAD WAUKEGAN IL 60085 LAKE 8473604000 140088 THE UNIVERSITY OF CHICAGO MEDICAL CENTER 5841 SOUTH MARYLAND CHICAGO IL 60637 COOK 7737021000 140089 MC DONOUGH DISTRICT HOSPITAL 525 EAST GRANT STREET MACOMB IL 61455 MCDONOUGH 3098334101 14008F MARION VA MEDICAL CENTER 2401 WEST MAIN STREET MARION IL 62959 WILLIAMSON 6189975311 140091 THE CARLE FOUNDATION HOSPITAL 611 WEST PARK STREET URBANA IL 61801 CHAMPAIGN 2173833311 140093 PRESENCE UNITED SAMARITANS MEDICAL CENTER 812 N LOGAN DANVILLE IL 61832 VERMILION 2174435000 140095 SAINT ANTHONY HOSPITAL 2875 WEST 19TH STREET CHICAGO IL 60623 COOK 7735211710 14009F US AIR FORCE HOSP CHANUTE AFB RANTOUL IL 61866 CHAMPAIGN 140100 MIDWESTERN REGION MED CENTER 2520 ELISHA AVENUE ZION IL 60099 LAKE 8478724561 140101 MORRIS HOSPITAL & HEALTHCARE CENTERS 150 W HIGH ST MORRIS IL 60450 GRUNDY 8159422932 140103 ST BERNARD HOSPITAL 326 W 64TH ST CHICAGO IL 60621 COOK 7739623900 140110 OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER 1100 EAST NORRIS DRIVE OTTAWA IL 61350 LASALLE 8154333100
140113 PRESENCE COVENANT MEDICAL CENTER 1400 WEST PARK AVENUE URBANA IL 61801 CHAMPAIGN 2173372000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 59 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 140114 SWEDISH COVENANT HOSPITAL 5145 N CALIFORNIA AVE CHICAGO IL 60625 COOK 7738788200 140115 THOREK MEMORIAL HOSPITAL 850 W IRVING PARK RD CHICAGO IL 60613 COOK 3125256780 140116 CENTEGRA HEALTH SYSTEM ‐ MC HENRY HOSPITAL 4201 MEDICAL CENTER DRIVE MCHENRY IL 60050 MCHENRY 8153445000 140117 PRESENCE RESURRECTION MEDICAL CENTER 7435 W TALCOTT AVENUE CHICAGO IL 60631 COOK 7737748000 140118 METROSOUTH MEDICAL CENTER 12935 S GREGORY BLUE ISLAND IL 60406 COOK 7085972000 140119 RUSH UNIVERSITY MEDICAL CENTER 1653 WEST CONGRESS PARKWAY CHICAGO IL 60612 COOK 3129425000 14011F US AIR FORCE HOSP SCOTT AFB BELLEVILLE IL 62225 ST. CLAIR 140120 PEKIN MEMORIAL HOSPITAL 600 SOUTH 13TH STREET PEKIN IL 61554 TAZEWELL 3093471151 140122 ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK ST HINSDALE IL 60521 DUPAGE 6308569000 140124 JOHN H STROGER JR HOSPITAL 1901 W HARRISON ST CHICAGO IL 60612 COOK 3128646000 140125 GATEWAY REGIONAL MEDICAL CENTER 2100 MADISON AVENUE GRANITE CITY IL 62040 MADISON 6187983175 140127 ADVOCATE BROMENN MEDICAL CENTER 1304 FRANKLIN AVENUE NORMAL IL 61761 MCLEAN 3094541400 14012E WARREN G MURRAY CHILDRENS CENTER 1717 W BROADWAY CENTRALIA IL 62801 MARION 140130 NORTHWESTERN LAKE FOREST HOSPITAL 660 N WESTMORELAND ROAD LAKE FOREST IL 60045 LAKE 8472345600 140133 HOLY CROSS HOSPITAL 2701 W 68TH STREET CHICAGO IL 60629 COOK 7738849000 140135 DECATUR MEMORIAL HOSPITAL 2300 NORTH EDWARD STREET DECATUR IL 62526 MACON 2178778121 140137 GREENVILLE REGIONAL HOSPITAL 200 HEALTHCARE DR GREENVILLE IL 62246 BOND 6186641230 14013E ILLINOIS CHILDRENS HOSP 2551 N CLARK ST CHICAGO IL 60614 COOK 140143 ST MARGARETS HOSPITAL 600 E 1ST ST SPRING VALLEY IL 61362 BUREAU 8156641176 140145 ST JOSEPHS HOSPITAL 9515 HOLY CROSS LN BREESE IL 62230 CLINTON 6185264511 140147 RICHLAND MEMORIAL HOSPITAL 800 EAST LOCUST OLNEY IL 62450 RICHLAND 6183952131 140148 MEMORIAL MEDICAL CENTER 701 N FIRST ST SPRINGFIELD IL 62781 SANGAMON 2177883000 140150 UNIVERSITY OF ILLINOIS HOSPITAL 1740 WEST TAYLOR ST SUITE 1400 CHICAGO IL 60612 COOK 3129963900 140155 PRESENCE ST MARYS HOSPITAL 500 W COURT ST KANKAKEE IL 60901 KANKAKEE 8159372490 140158 MERCY HOSPITAL AND MEDICAL CENTER 2525 S MICHIGAN AVE CHICAGO IL 60616 COOK 3125672000 14015E KANE CO SPRINGBROOK SANATORIUM 1329 N LAKE ST AURORA IL 60506 KANE 140160 FHN MEMORIAL HOSPITAL 1045 WEST STEPHENSON STREET FREEPORT IL 61032 STEPHENSON 8152354131 140161 SAINT JAMES HOSPITAL 2500 WEST REYNOLDS STREET PONTIAC IL 61764 LIVINGSTON 8158422828 140162 ST JOSEPH MEDICAL CENTER 2200 E WASHINGTON BLOOMINGTON IL 61701 MCLEAN 3096623311 140164 MEMORIAL HOSPITAL OF CARBONDALE 405 W JACKSON CARBONDALE IL 62902 JACKSON 6185490721
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 60 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 140166 ST MARYS HOSPITAL 1800 E LAKE SHORE DR DECATUR IL 62521 MACON 2174647000 140167 IROQUOIS MEMORIAL HOSPITAL 200 FAIRMAN STREET WATSEKA IL 60970 IROQUOIS 8154325201 140172 FRANCISCAN ST JAMES HEALTH 20201 S CRAWFORD AVENUE OLYMPIA FIELDS IL 60461 COOK 7087474000 140174 PRESENCE MERCY MEDICAL CENTER 1325 N HIGHLAND AVENUE AURORA IL 60506 KANE 6308592222 140176 CENTEGRA HEALTH SYSTEM ‐ WOODSTOCK HOSPITAL 3701 DOTY ROAD WOODSTOCK IL 60098 MCHENRY 8157885823 140177 JACKSON PARK HOSPITAL 7531 S STONY ISLAND AVE CHICAGO IL 60649 COOK 7739477500 140179 LITTLE COMPANY OF MARY HOSPITAL 2800 W 95TH ST EVERGREEN PARK IL 60805 COOK 7084226200 140180 PRESENCE SAINTS MARY AND ELIZABETH MEDICAL CENTER 2233 W DIVISION ST CHICAGO IL 60622 COOK 3127702000
140181 SOUTH SHORE HOSPITAL 8012 SOUTH CRANDON AVENUE CHICAGO IL 60617 COOK 7737680810 140182 ADVOCATE ILLINOIS MASONIC MEDICAL CENTER 836 WEST WELLINGTON AVENUE CHICAGO IL 60657 COOK 7739751600 140184 HEARTLAND REGIONAL MEDICAL CENTER 3333 W DE YOUNG MARION IL 62959 WILLIAMSON 6189987000 140185 MEMORIAL HOSPITAL 4500 MEMORIAL DRIVE BELLEVILLE IL 62226 ST. CLAIR 6182337750 140186 RIVERSIDE MEDICAL CENTER 350 N WALL ST KANKAKEE IL 60901 KANKAKEE 8159331671 140187 ST ELIZABETH HOSPITAL 211 S THIRD ST BELLEVILLE IL 62220 ST. CLAIR 6182342120 140189 SARAH BUSH LINCOLN HEALTH CENTER 1000 HEALTH CENTER DRIVE P O BOX 372 MATTOON IL 61938 COLES 2172582572 140191 INGALLS MEMORIAL HOSPITAL ONE INGALLS DRIVE HARVEY IL 60426 COOK 7083332300 140197 METHODIST HOSPITAL OF CHICAGO 5025 N PAULINA STREET CHICAGO IL 60640 COOK 7732719040 14019E HALCO SANATORIUM 1352 N LASALLE ST CHICAGO IL 60616 COOK 140200 ELMHURST MEMORIAL HOSPITAL 155 EAST BRUSH HILL ROAD ELMHURST IL 60126 DUPAGE 6308331400 140202 ADVOCATE CONDELL MEDICAL CENTER 801 S MILWAUKEE AVE LIBERTYVILLE IL 60048 LAKE 8479905200 140206 NORWEGIAN‐AMERICAN HOSPITAL 1044 N FRANCISCO AVE CHICAGO IL 60622 COOK 7732928200 140208 ADVOCATE CHRIST HOSPITAL & MEDICAL CENTER 4440 W 95TH STREET OAK LAWN IL 60453 COOK 7086848000 140209 METHODIST MEDICAL CENTER OF ILLINOIS 221 N E GLEN OAK AVE PEORIA IL 61636 PEORIA 3096725522 14020E ILLINOIS STATE PEDIATRIC INSTITUTE 1640 W ROOSEVELT RD CHICAGO IL 60608 COOK 140210 HARRISBURG MEDICAL CENTER 100 DOCTOR WARREN TUTTLE DR HARRISBURG IL 62946 SALINE 6182537671 140211 DELNOR COMMUNITY HOSPITAL 300 RANDALL RD GENEVA IL 60134 KANE 6302083000 140213 SILVER CROSS HOSPITAL AND MEDICAL CENTERS 1900 SILVER CROSS BLVD NEW LENOX IL 60451 WILL 8153001100 140217 PRESENCE SAINT JOSEPH HOSPITAL ‐ ELGIN 77 N AIRLITE STREET ELGIN IL 60123 KANE 8476953200 14021E MUNICIPAL CONTAGIOUS DISEASE HOSP 3026 S CALIFORNIA AVE CHICAGO IL 60608 COOK
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 61 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 140223 ADVOCATE LUTHERAN GENERAL HOSPITAL 1775 DEMPSTER ST PARK RIDGE IL 60068 COOK 8477232210 140224 PRESENCE SAINT JOSEPH HOSPITAL ‐ CHICAGO 2900 NORTH LAKE SHORE DRIVE CHICAGO IL 60657 COOK 7736653000 140228 SWEDISH AMERICAN HOSPITAL 1401 EAST STATE STREET ROCKFORD IL 61104 WINNEBAGO 8159684400 14022E SHRINERS HOSP FOR CHILDREN ‐ CHICAGO 2211 N OAK PARK AVE CHICAGO IL 60635 COOK 7733855419 140231 EDWARD HOSPITAL 801 SOUTH WASHINGTON NAPERVILLE IL 60540 DUPAGE 6305273000 140233 SAINT ANTHONY MEDICAL CENTER 5666 EAST STATE STREET ROCKFORD IL 61108 WINNEBAGO 8152262000 140234 ILLINOIS VALLEY COMMUNITY HOSPITAL 925 WEST ST PERU IL 61354 LASALLE 8152233300 140239 ROCKFORD MEMORIAL HOSPITAL 2400 NORTH ROCKTON AVENUE ROCKFORD IL 61103 WINNEBAGO 8159686861 140240 WESTLAKE COMMUNITY HOSPITAL 1225 LAKE ST MELROSE PARK IL 60160 COOK 7089384000 140242 CENTRAL DUPAGE HOSPITAL 25 NORTH WINFIELD ROAD WINFIELD IL 60190 DUPAGE 6306821600 14024E MADISON CO TUBERCULOSIS SANATORIUM P O BOX 536 TROY RD EDWARDSVILLE IL 62025 MADISON 140250 ADVOCATE SOUTH SUBURBAN HOSPITAL 17800 S KEDZIE AVE HAZEL CREST IL 60429 COOK 7087998000 140251 COMMUNITY FIRST MEDICAL CENTER 5645 W ADDISON STREET CHICAGO IL 60634 COOK 7732827000 140252 NORTHWEST COMMUNITY HOSPITAL 1 800 W CENTRAL ROAD ARLINGTON HEIGHTS IL 60005 COOK 8476181000 140258 ALEXIAN BROTHERS MEDICAL CENTER 1 800 W BIESTERFIELD RD ELK GROVE VILLAGE IL 60007 COOK 8474375500 14025E LIVINGSTON CO SANATORIUM EAST TORRANCE AVE PONTIAC IL 61764 LIVINGSTON 14026E ROCKFORD MUN TUBERCULOSIS SANATORIUM 1601 PARKVIEW AVE ROCKFORD IL 61107 WINNEBAGO 140275 GENESIS HEALTH SYSTEM 801 ILLINI DRIVE SILVIS IL 61282 ROCK ISLAND 3097929363 140276 LOYOLA UNIVERSITY MEDICAL CENTER 2160 S 1ST AVENUE MAYWOOD IL 60153 COOK 7082169000 14027E OUTLOOK CAMPAIGN CO TB SANATORIUM ROUTE 1 URBANA IL 61801 CHAMPAIGN 140280 TRINITY ROCK ISLAND 2701 17TH ST ROCK ISLAND IL 61201 ROCK ISLAND 3097795000 140281 NORTHWESTERN MEMORIAL HOSPITAL 251 E HURON ST CHICAGO IL 60611 COOK 3129262000 140286 KISHWAUKEE COMMUNITY HOSPITAL ONE KISH HOSPITAL DRIVE DEKALB IL 60115 DEKALB 8157561521 140288 ADVOCATE GOOD SAMARITAN HOSPITAL 3815 HIGHLAND AVENUE DOWNERS GROVE IL 60515 DUPAGE 6302755900 140289 ANDERSON HOSPITAL 6800 STATE ROUTE 162 MARYVILLE IL 62062 MADISON 6182885711 14028E MOOSEHEART HOSP C ST MOOSEHEART IL 60539 KANE 140290 ST ALEXIUS MEDICAL CENTER 1555 N BARRINGTON RD HOFFMAN ESTATES IL 60194 COOK 8478432000 140291 ADVOCATE GOOD SHEPHERD HOSPITAL 450 WEST HIGHWAY 22 BARRINGTON IL 60010 LAKE 8473819600 140292 ADVENTIST GLENOAKS 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 DUPAGE 6305456160 140294 CROSSROADS COMMUNITY HOSPITAL 8 DOCTORS PARK ROAD MOUNT VERNON IL 62864 JEFFERSON 6182445500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 62 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 140300 PROVIDENT HOSPITAL OF CHICAGO 500 E 51ST ST CHICAGO IL 60615 COOK 3125722000 140304 ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BOULEVARD BOLINGBROOK IL 60440 WILL 6302268100 140306 THC ‐ CHICAGO, INC D/B/A KINDRED HOSP SPRINGFIELD 701 NORTH WALNUT STREET SPRINGFIELD IL 62702 SANGAMON 2175281217
140307 METRO‐EAST SERVICES INC 1404 CROSS STREET SHILOH IL 62269 ST. CLAIR 6186071000 14030E OAK KNOLL SANATORIUM RURAL ROUTE 1 MACKINAW IL 61755 TAZEWELL 14032E SUNNY HILL SANATORIUM 501 ELLA AVE JOLIET IL 60433 WILL 14033E OAKLAWN MORGAN CO TB SANATORIUM ROUTE 4 JACKSONVILLE IL 62650 MORGAN 14034F NORTH CHICAGO VETERANS ADMINISTRATION HOSPITAL 3001 GREENBAY ROAD NORTH CHICAGO IL 60064 LAKE 8476881900
141300 THOMAS H BOYD MEMORIAL HOSPITAL 800 SCHOOL ST CARROLLTON IL 62016 GREENE 2179426946 141301 KIRBY MEDICAL CENTER 1111 N STATE ST MONTICELLO IL 61856 PIATT 2177622115 141302 MIDWEST MEDICAL CENTER ONE MEDICAL CENTER DRIVE GALENA IL 61036 JO DAVIESS 8157771340 141303 DR JOHN WARNER HOSPITAL 422 W WHITE ST CLINTON IL 61727 DE WITT 2179359571 141304 GENESIS MEDICAL CENTER, ALEDO 409 NW 9TH AVENUE ALEDO IL 61231 MERCER 3095825301 141305 MEMORIAL HOSPITAL 1454 N COUNTY ROAD 2050 CARTHAGE IL 62321 HANCOCK 2173578850 141306 COMMUNITY MEMORIAL HOSPITAL 400 CALDWELL STAUNTON IL 62088 MACOUPIN 6186352200 141307 PINCKNEYVILLE COMMUNITY HOSPITAL 5383 STATE ROUTE 154 PINCKNEYVILLE IL 62274 PERRY 6183572187 141308 WASHINGTON COUNTY HOSPITAL* 705 S GRAND NASHVILLE IL 62263 WASHINGTON 6183272264 141309 ADVOCATE EUREKA HOSPITAL 101 S MAJOR ST EUREKA IL 61530 WOODFORD 3094672371 141310 OSF SAINT PAUL MEDICAL CENTER 1401 E 12TH STREET MENDOTA IL 61342 LASALLE 8155397461 141311 FAIRFIELD MEMORIAL HOSPITAL 1 303 N W 11TH STREET FAIRFIELD IL 62837 WAYNE 6188422611 141312 ROCHELLE COMMUNITY HOSPITAL 900 N 2ND ST ROCHELLE IL 61068 OGLE 8155622181 141313 MASON DISTRICT HOSPITAL 615 NORTH PROMENADE STREET,P O BOX 530 HAVANA IL 62644 MASON 3095434431 141315 ILLINI COMMUNITY HOSPITAL 640 W WASHINGTON PITTSFIELD IL 62363 PIKE 2172852113 141316 HOOPESTON COMMUNITY MEMORIAL HOSPITAL 701 EAST ORANGE STREET HOOPESTON IL 60942 VERMILION 2172835531 141317 GIBSON COMMUNITY HOSPITAL 1120 N MELVIN STREET GIBSON CITY IL 60936 FORD 2177844251 141318 OSF HOLY FAMILY MEDICAL CENTER 1000 W HARLEM AVENUE MONMOUTH IL 61462 WARREN 3097343141 141319 HAMMOND HENRY HOSPITAL 600 N COLLEGE AVENUE GENESEO IL 61254 HENRY 3099446431 141320 PARIS COMMUNITY HOSPITAL 721 E COURT STREET PARIS IL 61944 EDGAR 2174654141 141321 FRANKLIN HOSPITAL 201 BAILEY LANE BENTON IL 62812 FRANKLIN 6184393761
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 63 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 141322 ABRAHAM LINCOLN MEMORIAL HOSPITAL 200 STAHLHUT DRIVE LINCOLN IL 62656 LOGAN 2177322161 141323 MASSAC MEMORIAL HOSPITAL 28 CHICK STREET, PO BOX 850 METROPOLIS IL 62960 MASSAC 6185242176 141324 FERRELL HOSPITAL COMMUNITY FOUNDATIONS 1201 PINE STREET ELDORADO IL 62930 SALINE 6182733361 141325 OSF SAINT LUKES MEDICAL CENTER 1051 WEST SOUTH STREET KEWANEE IL 61443 HENRY 3098533361 141326 HAMILTON MEMORIAL HOSPITAL DISTRICT 611 S MARSHALL AVENUE MCLEANSBORO IL 62859 HAMILTON 6186432361 141327 WABASH GENERAL HOSPITAL 1 1418 COLLEGE DRIVE MOUNT CARMEL IL 62863 WABASH 6182628621 141328 HARDIN COUNTY GENERAL HOSPITAL FERRELL ROAD ROSICLARE IL 62982 HARDIN 6182856634 141329 MORRISON COMMUNITY HOSPITAL 303 N JACKSON STREET MORRISON IL 61270 WHITESIDE 8157724003 141330 HOPEDALE MEDICAL COMPLEX 107 TREMONT STREET HOPEDALE IL 61747 TAZEWELL 3094493321 141331 MARSHALL BROWNING HOSPITAL 900 NORTH WASHINGTON STREET DU QUOIN IL 62832 PERRY 6185422146 141332 HILLSBORO AREA HOSPITAL 1200 E TREMONT STREET HILLSBORO IL 62049 MONTGOMERY 2175326111 141333 SARAH D CULBERTSON MEMORIAL HOSPITAL 238 SOUTH CONGRESS STREET RUSHVILLE IL 62681 SCHUYLER 2173224321 141334 ST JOSEPH MEMORIAL HOSPITAL 2 SOUTH HOSPITAL DRIVE MURPHYSBORO IL 62966 JACKSON 6186843156 141335 MERCY HARVARD HOSPITAL 901 GRANT STREET HARVARD IL 60033 MCHENRY 8159435431 141336 ST JOSEPH'S HOSPITAL 12866 TROXLER AVENUE HIGHLAND IL 62249 MADISON 6186512600 141337 PERRY MEMORIAL HOSPITAL 530 PARK AVENUE EAST PRINCETON IL 61356 BUREAU 8158752811 141338 MEMORIAL HOSPITAL 1900 STATE STREET CHESTER IL 62233 RANDOLPH 6188264581 141339 TAYLORVILLE MEMORIAL HOSPITAL 201 EAST PLEASANT STREET TAYLORVILLE IL 62568 CHRISTIAN 2178243331 141340 VALLEY WEST COMMUNITY HOSPITAL 1301 NORTH MAIN STREET SANDWICH IL 60548 DEKALB 8157868484 141341 PANA COMMUNITY HOSPITAL 101 E NINTH STREET PANA IL 62557 CHRISTIAN 2175622131 141342 UNION COUNTY HOSPITAL 517 NORTH MAIN STREET ANNA IL 62906 UNION 6188334511 141343 CRAWFORD MEMORIAL HOSPITAL 1000 NORTH ALLEN STREET ROBINSON IL 62454 CRAWFORD 6185462514 141344 LAWRENCE COUNTY MEMORIAL HOSPITAL 2200 STATE ST LAWRENCEVILLE IL 62439 LAWRENCE 6189431000 141345 SALEM TOWNSHIP HOSPITAL 1201 RICKER DRIVE SALEM IL 62881 MARION 6185483194 141346 FAYETTE COUNTY HOSPITAL 7TH AND TAYLOR VANDALIA IL 62471 FAYETTE 6182831231 141347 CARLINVILLE AREA HOSPITAL 20733 N BROAD STREET CARLINVILLE IL 62626 MACOUPIN 2178543141 141348 RED BUD REGIONAL HOSPITAL 325 SPRING STREET RED BUD IL 62278 RANDOLPH 6182823831 141349 SPARTA COMMUNITY HOSPITAL 818 E BROADWAY SPARTA IL 62286 RANDOLPH 6184432177 141350 ST FRANCIS HOSPITAL 1215 FRANCISCAN DR LITCHFIELD IL 62056 MONTGOMERY 2173242191 141351 CLAY COUNTY HOSPITAL 911 STACY BURK DRIVE FLORA IL 62839 CLAY 6186622131
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 64 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 141990 HILL TOP CENTER 502 NORTH WAUKEGAN ROAD LAKE BLUFF IL 60044 LAKE 8472951550 142006 THC CHICAGO INC DBA KINDRED HOSP 225 EDWARD STREET SYCAMORE IL 60178 DEKALB 8158952144 142008 THC CHICAGO INC DBA KINDRED HOSP CHGO 365 E NORTH AVE NORTHLAKE IL 60164 COOK 7732672620 142009 THC CHICAGO INC DBA KINDRED CHICAGO 4058 W MELROSE CHICAGO IL 60641 COOK 7737367000 142010 RML SPECIALTY HOSPITAL 5601 S COUNTY LINE RD HINSDALE IL 60521 DUPAGE 6302864000 142011 PRESENCE HOLY FAMILY MEDICAL CENTER 100 NORTH RIVER ROAD DES PLAINES IL 60016 COOK 8472971800 142013 GREATER PEORIA SPECIALTY HOSPITAL 500 W ROMEO B GARRETT AVENUE PEORIA IL 61605 PEORIA 3096801500 142014 VIBRA HOSPITAL OF SPRINGFIELD 701 N WALNUT SPRINGFIELD IL 62702 SANGAMON 2175281217 143025 SCHWAB REHABILITATION HOSPITAL 1401 S CALIFORNIA BLVD CHICAGO IL 60608 COOK 7735222010 143026 REHABILITATION INSTITUTE OF CHICAGO 345 E SUPERIOR ST CHICAGO IL 60611 COOK 3122383305 143027 MARIANJOY REHABILITATION HOSPITAL 26 W 171 ROOSEVELT ROAD WHEATON IL 60187 DUPAGE 6305887817 143028 VAN MATRE HEALTHSOUTH REHABILITATION HOSPITAL 950 S MULFORD RD ROCKFORD IL 61108 WINNEBAGO 8153818548
143300 ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO 225 E CHICAGO CHICAGO IL 60611 COOK 7738804000
143301 LARABIDA CHILDRENS HOSPITAL IE 65TH ST AT LAKE MICHIGAN CHICAGO IL 60649 COOK 7733636700 143302 SHRINERS HOSPITAL FOR CHILDREN 2211 NORTH OAK PARK AVE CHICAGO IL 60707 COOK 7736225400 144005 AURORA CHICAGO LAKESHORE HOSPITAL 4840 N MARINE DR CHICAGO IL 60640 COOK 7738789700 144009 RIVEREDGE HOSPITAL 8311 WEST ROOSEVELT ROAD FOREST PARK IL 60130 COOK 7087717000 144010 CHICAGO‐READ MENTAL HEALTH CENTER 4200 N OAK PARK AVE CHICAGO IL 60634 COOK 7737944000 144016 ALTON MENTAL HEALTH CENTER 4500 COLLEGE AVENUE ALTON IL 62002 MADISON 6184743800 144021 ANDREW MCFARLAND MENTAL HLTH CTR 901 SOUTHWIND RD SPRINGFIELD IL 62703 SANGAMON 2177866900 144026 HARTGROVE HOSPITAL 5730 W ROOSEVELT ROAD CHICAGO IL 60644 COOK 7734131700 144028 JOHN J MADDEN MENTAL HEALTH CENTER 1200 S FIRST AVE HINES IL 60141 COOK 7085317202 144029 PAVILION FOUNDATION,THE 809 W CHURCH ST CHAMPAIGN IL 61820 CHAMPAIGN 2173731700 144031 ALEXIAN BROTHERS BEHAVIORAL HLTH HOSP 1650 MOON LAKE BLVD HOFFMAN ESTATES IL 60194 COOK 8478821600 144034 BHC STREAMWOOD HOSPITAL INC 1400 E IRVING PARK ROAD STREAMWOOD IL 60107 COOK 6308379000 144035 LINDEN OAKS HOSPITAL 801 SOUTH WASHINGTON ST NAPERVILLE IL 60540 DUPAGE 6303055500 144037 ELGIN MENTAL HEALTH CENTER 750 S STATE ST ELGIN IL 60123 KANE 8477421040 144038 CHOATE MENTAL HEALTH & DEVELOPMENT CTR 1000 N MAIN ST ANNA IL 62906 UNION 6188335161 144039 GARFIELD PARK HOSPITAL 520 N RIDGEWAY AVE CHICAGO IL 60624 COOK 7732653700
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 65 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 144040 CHICAGO BEHAVIORAL HOSPITAL 555 WILSON LANE DES PLAINES IL 60016 COOK 8477685430 149801 UNIVERSITY OF CHICAGO HOSPITALS 5841 SOUTH MARYLAND CHICAGO IL 60637 COOK 7737021000 149802 LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH 1ST AVENUE MAYWOOD IL 60153 COOK 7082169000 149803 RUSH UNIVERSITY MEDICAL CENTER 1653 WEST CONGRESS PARKWAY CHICAGO IL 60612 COOK 3129425000 149804 CHILDREN'S MEMORIAL HOSPITAL 2300 CHILDRENS PLAZA BOX #37 CHICAGO IL 60614 COOK 7738804092 149805 UNIVERSITY OF ILLINOIS MEDICAL CENTER 1740 WEST TAYLOR, SUITE 1400 CHICAGO IL 60612 COOK 3129963900 149806 NORTHWESTERN MEMORIAL HOSPITAL 251 EAST HURON STREET CHICAGO IL 60611 COOK 3126951705 149807 ST FRANCIS MEDICAL CENTER TRANSPLANT 530 NE GLEN OAK AVENUE PEORIA IL 61637 PEORIA 3096554101 149808 MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET ‐ TRANSPLANT SERVICES SPRINGFIELD IL 62781 SANGAMON 2177577886 149809 ADVOCATE CHRIST MEDICAL CENTER 4400 WEST 95TH STREET OAK LAWN IL 60453 COOK 7086842653 150001 JOHNSON MEMORIAL HOSPITAL 1125 W JEFFERSON ST FRANKLIN IN 46131 JOHNSON 3177363300 150002 METHODIST HOSPITALS INC 600 GRANT ST GARY IN 46402 LAKE 2198864000 150004 FRANCISCAN HEALTH HAMMOND 5454 HOHMAN AVE HAMMOND IN 46320 LAKE 2199322300 150005 HENDRICKS REGIONAL HEALTH 1000 E MAIN ST DANVILLE IN 46122 HENDRICKS 3177454451 150006 LA PORTE HOSPITAL 1007 LINCOLNWAY LA PORTE IN 46350 LAPORTE 2193261234 150007 COMMUNITY HOWARD REGIONAL HEALTH INC 3500 S LAFOUNTAIN ST KOKOMO IN 46902 HOWARD 7654538547 150008 ST CATHERINE HOSPITAL INC 4321 FIR ST EAST CHICAGO IN 46312 LAKE 2193927004 150009 CLARK MEMORIAL HOSPITAL 1220 MISSOURI AVE JEFFERSONVILLE IN 47130 CLARK 8122832147 150010 ST VINCENT KOKOMO 1907 W SYCAMORE ST KOKOMO IN 46904 HOWARD 7654525611 150011 MARION GENERAL HOSPITAL 441 N WABASH AVE MARION IN 46952 GRANT 7656607000 150012 SAINT JOSEPH REGIONAL MEDICAL CENTER 5215 HOLY CROSS PKWY MISHAWAKA IN 46545 ST. JOSEPH 5743355000 150015 FRANCISCAN HEALTH MICHIGAN CITY 301 W HOMER ST MICHIGAN CITY IN 46360 LAPORTE 2198798511 150017 LUTHERAN HOSPITAL OF INDIANA 7950 W JEFFERSON BLVD FORT WAYNE IN 46804 ALLEN 2604357001 150018 ELKHART GENERAL HOSPITAL 600 E BLVD ELKHART IN 46514 ELKHART 5742942621 15001F US ARMY HOSP FT BENJAMIN HARRISON INDIANAPOLIS IN 46216 150021 PARKVIEW REGIONAL MEDICAL CENTER 11109 PARKVIEW PLAZA DRIVE FORT WAYNE IN 46845 ALLEN 2602661000 150022 FRANCISCAN HEALTH CRAWFORDSVILLE 1710 LAFAYETTE RD CRAWFORDSVILLE IN 47933 MONTGOMERY 7653622800 150023 UNION HOSPITAL INC 1606 N SEVENTH ST TERRE HAUTE IN 47804 VIGO 8122387606 150024 ESKENAZI HEALTH 720 ESKENAZI AVENUE INDIANAPOLIS IN 46202 3178804818 150026 IU HEALTH GOSHEN HOSPITAL 200 HIGH PARK AVE GOSHEN IN 46526 ELKHART 5743641000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 66 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 15002F VA NORTHERN INDIANA HEALTH CARE SYSTEM‐FT WAYNE 2121 LAKE AVENUE FORT WAYNE IN 46805 ALLEN 2604265431
150030 HENRY COUNTY MEMORIAL HOSPITAL 1000 N 16TH ST NEW CASTLE IN 47362 HENRY 7655210890 150034 ST MARY MEDICAL CENTER INC 1500 S LAKE PARK AVE HOBART IN 46342 LAKE 2199420551 150035 PORTER REGIONAL HOSPITAL 85 EAST US HWY 6 VALPARAISO IN 46383 PORTER 2199838300 150037 HANCOCK REGIONAL HOSPITAL 801 N STATE ST GREENFIELD IN 46140 HANCOCK 3174625544 15003F RICHARD L ROUDEBUSH VA MEDICAL CENTE 1481 W TENTH STREET INDIANAPOLIS IN 46202 3175545404 150042 GOOD SAMARITAN HOSPITAL 520 S 7TH ST VINCENNES IN 47591 KNOX 8128825220 150044 FLOYD MEMORIAL HOSPITAL AND HEALTH SERVICES 1850 STATE ST NEW ALBANY IN 47150 FLOYD 8129495500 150045 DEKALB HEALTH 1316 E SEVENTH ST AUBURN IN 46706 DEKALB 2609254600 150046 TERRE HAUTE REGIONAL HOSPITAL 3901 S SEVENTH ST TERRE HAUTE IN 47802 VIGO 8122320021 150047 ST JOSEPH HOSPITAL 700 BROADWAY FORT WAYNE IN 46802 ALLEN 2604253000 150048 REID HEALTH 1100 REID PKWY RICHMOND IN 47374 WAYNE 7659833000 15004F VA NORTHERN INDIANA HLTH CARE SYSTEM‐MARION 1700 EAST 38TH STREET MARION IN 46953 GRANT 7656743321 CAMPUS 150051 INDIANA UNIVERSITY HEALTH BLOOMINGTON HOSPITAL 601 W SECOND ST BLOOMINGTON IN 47403 MONROE 8123539555
150056 INDIANA UNIVERSITY HEALTH 1701 N SENATE BLVD INDIANAPOLIS IN 46202 3179625900 150057 FRANCISCAN HEALTH MOORESVILLE 1201 HADLEY RD MOORESVILLE IN 46158 MORGAN 3178311160 150058 MEMORIAL HOSPITAL OF SOUTH BEND 615 N MICHIGAN ST SOUTH BEND IN 46601 ST. JOSEPH 5746471000 150059 RIVERVIEW HEALTH 395 WESTFIELD RD NOBLESVILLE IN 46060 HAMILTON 3177767108 15005F US AIR FORCE HOSP BUNKER HILL AFB PERU IN 46970 MIAMI 150061 DAVIESS COMMUNITY HOSPITAL 1314 E WALNUT ST WASHINGTON IN 47501 DAVIESS 8122542760 150064 FAYETTE REGIONAL HEALTH SYSTEM 1941 VIRGINIA AVE CONNERSVILLE IN 47331 FAYETTE 7658255131 150065 SCHNECK MEDICAL CENTER 411 W TIPTON ST SEYMOUR IN 47274 JACKSON 8125222349 150069 KING'S DAUGHTERS' HEALTH 1373 EAST SR 62 MADISON IN 47250 JEFFERSON 8128010105 15006F US PENITENTIARY HOSP ROUTE 1 TERRE HAUTE IN 47808 VIGO 150072 MEMORIAL HOSPITAL 1101 MICHIGAN AVE LOGANSPORT IN 46947 CASS 5747537541 150074 COMMUNITY HOSPITAL EAST 1500 N RITTER AVE INDIANAPOLIS IN 46219 3173555411 150075 BLUFFTON REGIONAL MEDICAL CENTER 303 S MAIN ST BLUFFTON IN 46714 WELLS 2608243210 150076 SAINT JOSEPH REGIONAL MEDICAL CENTER ‐ PLYMOUTH 1915 LAKE AVE PLYMOUTH IN 46563 MARSHALL 5749484000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 67 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 150082 DEACONESS HOSPITAL INC 600 MARY ST EVANSVILLE IN 47747 VANDERBURGH 8124505000 150084 ST VINCENT HOSPITAL & HEALTH SERVICES 2001 W 86TH ST INDIANAPOLIS IN 46260 3173387000 150086 DEARBORN COUNTY HOSPITAL 600 WILSON CREEK RD LAWRENCEBURG IN 47025 DEARBORN 8125371010 150088 ST VINCENT ANDERSON REGIONAL HOSPITAL INC 2015 JACKSON ST ANDERSON IN 46016 MADISON 7656468373 150089 INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL 2401 UNIVERSITY AVE MUNCIE IN 47303 DELAWARE 7657473111
150090 FRANCISCAN HEALTH DYER 24 JOLIET ST DYER IN 46311 LAKE 2198652141 150091 PARKVIEW HUNTINGTON HOSPITAL 2001 STULTS RD HUNTINGTON IN 46750 HUNTINGTON 2603553000 150097 MAJOR HOSPITAL 150 W WASHINGTON ST SHELBYVILLE IN 46176 SHELBY 3173923211 15009E NORTHERN INDIANA CHILDRENS HOSP 1234 N NOTRE DAME AVE SOUTH BEND IN 46622 150100 ST MARY'S MEDICAL CENTER 3700 WASHINGTON AVE EVANSVILLE IN 47750 VANDERBURGH 8124854000 150101 PARKVIEW WHITLEY HOSPITAL 1260 E SR 205 COLUMBIA CITY IN 46725 WHITLEY 2602489301 150102 STARKE HOSPITAL 102 E CULVER RD KNOX IN 46534 STARKE 5747721102 150104 WITHAM HEALTH SERVICES 2605 N LEBANON ST LEBANON IN 46052 BOONE 7654858000 150109 FRANCISCAN HEALTH LAFAYETTE 1701 S CREASY LN LAFAYETTE IN 47905 TIPPECANOE 7655024334 15010E NOTRE DAME UNIVERSITY HOSP NOTRE DAME IN 46556 ST. JOSEPH 150112 COLUMBUS REGIONAL HOSPITAL 2400 E 17TH ST COLUMBUS IN 47201 BARTHOLOMEW 8123794441 150113 COMMUNITY HOSPITAL OF ANDERSON AND MADISON 1515 N MADISON AVE ANDERSON IN 46011 MADISON 7652984242 COUNTY 150115 MEMORIAL HOSPITAL AND HEALTH CARE CENTER 800 W 9TH ST JASPER IN 47546 DUBOIS 8129962345 15011E CULVER MILITARY ACADEMY HOSP UNIT CULVER IN 46511 MARSHALL 150125 COMMUNITY HOSPITAL 901 MACARTHUR BLVD MUNSTER IN 46321 LAKE 2198361600 150126 FRANCISCAN HEALTH CROWN POINT 1201 S MAIN ST CROWN POINT IN 46307 LAKE 2197576100 150128 COMMUNITY HOSPITAL SOUTH 1402 E COUNTY LINE RD S INDIANAPOLIS IN 46227 3178877000 15012E NEWBY HOSP HANOVER COLLEGE HANOVER IN 47243 JEFFERSON 150133 KOSCIUSKO COMMUNITY HOSPITAL 2101 E DUBOIS DR WARSAW IN 46580 KOSCIUSKO 5742673200 150146 PARKVIEW NOBLE HOSPITAL 401 SAWYER RD KENDALLVILLE IN 46755 NOBLE 2603478700 150149 WOMEN'S HOSPITAL THE 4199 GATEWAY BLVD NEWBURGH IN 47630 WARRICK 8128424200 150150 DUPONT HOSPITAL LLC 2520 E DUPONT RD FORT WAYNE IN 46825 ALLEN 2604163000 150153 ST VINCENT HEART CENTER OF INDIANA LLC 10580 N MERIDIAN ST INDIANAPOLIS IN 46290 HAMILTON 3175835000 150157 ST VINCENT CARMEL HOSPITAL INC 13500 N MERIDIAN ST CARMEL IN 46032 HAMILTON 3175827000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 68 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 150158 IU HEALTH WEST HOSPITAL 1111 N RONALD REAGAN PKWY AVON IN 46123 HENDRICKS 3172173000 150160 ORTHOINDY HOSPITAL 8400 NORTHWEST BLVD INDIANAPOLIS IN 46278 3179561000 150161 INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 11700 N MERIDIAN ST CARMEL IN 46032 HAMILTON 3176882000 150162 FRANCISCAN HEALTH INDIANAPOLIS 8111 S EMERSON AVE INDIANAPOLIS IN 46237 3175285000 150165 FRANCISCAN HEALTH MUNSTER 701 SUPERIOR AVE MUNSTER IN 46321 LAKE 2199224200 150166 PINNACLE HOSPITAL 9301 CONNECTICUT DR CROWN POINT IN 46307 LAKE 2197562100 150167 ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC 11130 PARKVIEW CIRCLE DR FORT WAYNE IN 46845 ALLEN 2606724050 150168 THE ORTHOPAEDIC HOSPITAL OF LUTHERAN HEALTH 7952 W JEFFERSON BLVD FORT WAYNE IN 46804 ALLEN 2604352999 NETWOR 150169 COMMUNITY HOSPITAL NORTH 7150 CLEARVISTA DR INDIANAPOLIS IN 46256 3176215335 150172 PHYSICIANS' MEDICAL CENTER LLC 4023 REAS LN NEW ALBANY IN 47150 FLOYD 8122067660 150173 INDIANA UNIVERSITY HEALTH ARNETT HOSPITAL 5165 MCCARTY LN LAFAYETTE IN 47905 TIPPECANOE 7654488000 150175 THE HEART HOSPITAL AT DEACONESS GATEWAY LLC 4007 GATEWAY BLVD NEWBURGH IN 47630 WARRICK 8128424784 150176 KENTUCKIANA MEDICAL CENTER LLC 4601 MEDICAL PLAZA WAY CLARKSVILLE IN 47129 CLARK 8122803300 150177 UNITY MEDICAL AND SURGICAL HOSPITAL 4455 EDISON LAKES PKWY MISHAWAKA IN 46545 ST. JOSEPH 5742316800 150179 FAIRBANKS 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 3178498222 150181 ST VINCENT FISHERS HOSPITAL INC 13861 OLIO ROAD FISHERS IN 46037 HAMILTON 3174159000 150182 FRANCISCAN HEALTH CARMEL 12188 B NORTH MERIDIAN STREET CARMEL IN 46032 HAMILTON 3177054500 150183 MONROE HOSPITAL 4011 S MONROE MEDICAL PARK BLVD BLOOMINGTON IN 47403 MONROE 8128251111 151300 COMMUNITY HOSPITAL OF BREMEN INC 1020 HIGH RD BREMEN IN 46506 MARSHALL 5745462211 151301 ST VINCENT RANDOLPH HOSPITAL INC 473 E GREENVILLE AVE WINCHESTER IN 47394 RANDOLPH 7655840004 151302 INDIANA UNIVERSITY HEALTH BLACKFORD HOSPITAL 410 PILGRIM BLVD HARTFORD CITY IN 47348 BLACKFORD 7653480300 151303 ST VINCENT JENNINGS HOSPITAL INC 301 HENRY ST NORTH VERNON IN 47265 JENNINGS 8123524200 151304 RUSH MEMORIAL HOSPITAL 1300 N MAIN ST RUSHVILLE IN 46173 RUSH 7659327513 151305 PULASKI MEMORIAL HOSPITAL 616 E 13TH ST WINAMAC IN 46996 PULASKI 5749462100 151306 INDIANA UNIVERSITY HEALTH PAOLI HOSPITAL 642 W HOSPITAL RD PAOLI IN 47454 ORANGE 8127232811 151307 ST VINCENT WILLIAMSPORT HOSPITAL INC 412 N MONROE ST WILLIAMSPORT IN 47993 WARREN 7657624000 151308 ST VINCENT MERCY HOSPITAL 1331 S A ST ELWOOD IN 46036 MADISON 7655524743 151309 ST VINCENT CLAY HOSPITAL INC 1206 E NATIONAL AVE BRAZIL IN 47834 CLAY 8124422500 151310 PARKVIEW WABASH HOSPITAL, INC 710 N EAST ST WABASH IN 46992 WABASH 2605692160
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 69 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 151311 INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC 1000 S MAIN ST TIPTON IN 46072 TIPTON 7656758500 151312 INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL 720 SOUTH SIXTH ST MONTICELLO IN 47960 WHITE 5745837111
151313 WOODLAWN HOSPITAL 1400 E 9TH ST ROCHESTER IN 46975 FULTON 5742233141 151314 ST VINCENT SALEM HOSPITAL INC 911 N SHELBY ST SALEM IN 47167 WASHINGTON 8128835881 151315 CAMERON MEMORIAL COMMUNITY HOSPITAL INC 416 E MAUMEE ST ANGOLA IN 46703 STEUBEN 2606652141 151316 ST VINCENT FRANKFORT HOSPITAL INC 1300 S JACKSON ST FRANKFORT IN 46041 CLINTON 7656563000 151317 GREENE COUNTY GENERAL HOSPITAL 1185 N 1000 W LINTON IN 47441 GREENE 8128472281 151318 DUKES MEMORIAL HOSPITAL 275 W 12TH ST PERU IN 46970 MIAMI 7654728000 151319 GIBSON GENERAL HOSPITAL 1808 SHERMAN DR PRINCETON IN 47670 GIBSON 8123853401 151320 JAY COUNTY HOSPITAL 500 W VOTAW ST PORTLAND IN 47371 JAY 2607267131 151322 PERRY COUNTY MEMORIAL HOSPITAL 8885 SR 237 TELL CITY IN 47586 PERRY 8125477011 151323 PARKVIEW LAGRANGE HOSPITAL 207 N TOWNLINE RD LAGRANGE IN 46761 LAGRANGE 2604639000 151324 FRANCISCAN HEALTH RENSSELAER, INC 1104 E GRACE ST RENSSELAER IN 47978 JASPER 2198665141 151325 ST MARY'S WARRICK HOSPITAL, INC 1116 MILLIS AVE BOONVILLE IN 47601 WARRICK 8128974800 151326 UNION HOSPITAL CLINTON 801 S MAIN ST CLINTON IN 47842 VERMILLION 7658321234 151327 SULLIVAN COUNTY COMMUNITY HOSPITAL 2200 N SECTION ST SULLIVAN IN 47882 SULLIVAN 8122684311 151328 INDIANA UNIVERSITY HEALTH BEDFORD HOSPITAL 2900 W 16TH ST BEDFORD IN 47421 LAWRENCE 8122751200 151329 MARGARET MARY HEALTH 321 MITCHELL AVE BATESVILLE IN 47006 RIPLEY 8129346624 151330 ADAMS MEMORIAL HOSPITAL 1100 MERCER AVE DECATUR IN 46733 ADAMS 2607242145 151331 HARRISON COUNTY HOSPITAL 1141 HOSPITAL DR NW CORYDON IN 47112 HARRISON 8127384251 151332 DECATUR COUNTY MEMORIAL HOSPITAL 720 N LINCOLN ST GREENSBURG IN 47240 DECATUR 8126634331 151333 PUTNAM COUNTY HOSPITAL 1542 S BLOOMINGTON ST GREENCASTLE IN 46135 PUTNAM 7656552620 151334 SCOTT MEMORIAL HOSPITAL 1451 N GARDNER ST SCOTTSBURG IN 47170 SCOTT 8127523456 151335 ST VINCENT DUNN HOSPITAL INC 1600 23RD ST BEDFORD IN 47421 LAWRENCE 8122753331 151992 MIDLAND HOUSE INC 3940 E 56TH ST INDIANAPOLIS IN 46220 3172572201 152007 KINDRED HOSPITAL INDIANAPOLIS 1700 W 10TH ST INDIANAPOLIS IN 46222 3176364400 152008 KINDRED HOSPITAL‐ INDIANAPOLIS SOUTH 607 GREENWOOD SPRINGS DRIVE GREENWOOD IN 46143 JOHNSON 3178888155 152012 KINDRED HOSPITAL NORTHWEST INDIANA 5454 HOHMAN AVE 5TH FL HAMMOND IN 46320 LAKE 2198525305 152013 KINDRED HOSPITAL INDIANAPOLIS NORTH 8060 KNUE ROAD INDIANAPOLIS IN 46250 3178138900
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 70 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 152014 SELECT SPECIALTY HOSPITAL‐EVANSVILLE 400 SE 4TH ST EVANSVILLE IN 47713 VANDERBURGH 8124212330 152016 SELECT SPECIALTY HOSPITAL‐FORT WAYNE 700 BROADWAY 7TH FL EFORT WAYNE IN 46802 ALLEN 2604253840 152018 KINDRED HOSPITAL NORTHERN INDIANA 215 W 4TH ST STE 200 MISHAWAKA IN 46544 ST. JOSEPH 5742522000 152020 ST VINCENT SETON SPECIALTY HOSPITAL, INDIANAPOLIS 8050 TOWNSHIP LINE RD INDIANAPOLIS IN 46260 3174158500
152024 REGENCY HOSPITAL OF NORTHWEST INDIANA 4321 FIR ST 4TH FL EAST CHICAGO IN 46312 LAKE 2193927799 152025 CENTRAL INDIANA AMG SPECIALTY HOSPITAL LLC 2401 W UNIVERSITY AVE 5TH FLOOR EAST TOWER MUNCIE IN 47303 DELAWARE 7657515253 152027 VIBRA HOSPITAL OF FORT WAYNE 2200 RANDALLIA DRIVE 5TH FLOOR FORT WAYNE IN 46805 ALLEN 2603992900 152028 VIBRA HOSPITAL OF NORTHWESTERN INDIANA 9509 GEORGIA ST CROWN POINT IN 46307 LAKE 2194722200 153025 HEALTHSOUTH DEACONESS REHABILITATION HOSPITAL 4100 COVERT AVE EVANSVILLE IN 47716 VANDERBURGH 8124769983
153028 REHABILITATION HOSPITAL OF INDIANA INC 4141 SHORE DR INDIANAPOLIS IN 46254 3173292000 153030 REHABILITATION HOSPITAL OF FORT WAYNE GENERAL PAR 7970 W JEFFERSON BLVD FORT WAYNE IN 46804 ALLEN 2604356100
153037 SOUTHERN INDIANA REHABILITATION HOSPITAL 3104 BLACKISTON BLVD NEW ALBANY IN 47150 FLOYD 8129416106 153039 COMMUNITY HOWARD SPECIALTY HOSPITAL 829 N DIXON RD KOKOMO IN 46901 HOWARD 7654526700 153042 LAFAYETTE REGIONAL REHABILITATION HOSPITAL 950 PARK EAST BLVD LAFAYETTE IN 47905 TIPPECANOE 7654474040 153043 COMMUNITY HEALTH NETWORK REHABILITATION 7343 CLEARVISTA DRIVE INDIANAPOLIS IN 46256 3175855400 HOSPITAL 154005 RIVER BEND HOSPITAL 2900 N RIVER RD WEST LAFAYETTE IN 47906 TIPPECANOE 7654632555 154008 LARUE D CARTER MEMORIAL HOSPITAL 2601 COLD SPRING RD INDIANAPOLIS IN 46222 3179414000 154009 HAMILTON CENTER INC 620 8TH AVE TERRE HAUTE IN 47804 VIGO 8122318285 154011 COMMUNITY MENTAL HEALTH CENTER INC 285 BIELBY RD LAWRENCEBURG IN 47025 DEARBORN 8125371302 154014 OTIS R BOWEN CENTER FOR HUMAN SERVICES INC 1535 PROVIDENT DR WARSAW IN 46580 KOSCIUSKO 5742677169 154018 RICHMOND STATE HOSPITAL 498 NW 18TH ST RICHMOND IN 47374 WAYNE 7659660511 154019 MADISON STATE HOSPITAL 711 GREEN RD MADISON IN 47250 JEFFERSON 8122652611 154020 REGIONAL MENTAL HEALTH CENTER 8555 TAFT ST MERRILLVILLE IN 46410 LAKE 2197694005 154021 GRANT‐BLACKFORD MENTAL HEALTH, INC 505 WABASH AVE MARION IN 46952 GRANT 7656623971 154024 VALLE VISTA HEALTH SYSTEM 898 E MAIN ST GREENWOOD IN 46143 JOHNSON 3178835300 154031 OAKLAWN PSYCHIATRIC CENTER INC 330 LAKEVIEW DR GOSHEN IN 46527 ELKHART 5745331234 154035 FOUR COUNTY COUNSELING CENTER 1015 MICHIGAN AVE LOGANSPORT IN 46947 CASS 5747225151 154041 BLOOMINGTON MEADOWS HOSPITAL 3600 N PROW RD BLOOMINGTON IN 47404 MONROE 8123318000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 71 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 154047 MICHIANA BEHAVIORAL HEALTH CENTER 1800 N OAK RD PLYMOUTH IN 46563 MARSHALL 5749363784 154050 NORTHEASTERN CENTER 1850 WESLEY RD AUBURN IN 46706 DEKALB 2609270726 154051 WELLSTONE REGIONAL HOSPITAL 2700 VISSING PARK RD JEFFERSONVILLE IN 47130 CLARK 8122848000 154052 PORTER‐STARKE SERVICES INC 701 WALL ST VALPARAISO IN 46383 PORTER 2195313500 154053 MERIDIAN SERVICES CORP 2401 W UNIVERSITY AVE MUNCIE IN 47303 DELAWARE 7657515377 154054 HARSHA BEHAVIORAL CENTER INC 1420 E CROSSING BLVD TERRE HAUTE IN 47802 VIGO 8122988888 154055 BRENTWOOD MEADOWS LLC 4488 ROSLIN RD NEWBURGH IN 47630 WARRICK 8128587200 154056 EVANSVILLE STATE HOSPITAL 3400 LINCOLN AVENUE EVANSVILLE IN 47714 VANDERBURGH 8124696800 154057 OPTIONS BEHAVIORAL HEALTH SYSTEM 5602 CAITO DRIVE INDIANAPOLIS IN 46226 3175444340 154058 DOCTORS NEUROPSYCHIATRIC HOSPITAL 417 S WHITLOCK ST BREMEN IN 46506 MARSHALL 5745460330 154059 SYCAMORE SPRINGS 833 PARK EAST BLVD LAFAYETTE IN 47905 TIPPECANOE 7657434400 154060 PARK CENTER, INC 1909 CAREW STREET FORT WAYNE IN 46805 ALLEN 2604893543 154061 RIVERCREST SPECIALTY HOSPITAL, LLC 1625 EAST JEFFERSON BLVD MISHAWAKA IN 46545 ST. JOSEPH 5744851703 154062 ASSURANCE HEALTH PSYCHIATRIC HOSPITAL 2725 ENTERPRISE DRIVE ANDERSON IN 46013 MADISON 3173726611 154063 NEUROPSYCHIATRIC HOSPITAL OF INDIANAPOLIS, LLC 6720 PARKDALE PLACE, SUITE 100 INDIANAPOLIS IN 46254 3177449200
159801 LUTHERAN HOSPITAL OF INDIANA TH 7950 W JEFFERSON BLVD FORT WAYNE IN 46804 ALLEN 2604357101 159802 ST VINCENT HOSPITAL 2001 W 86TH ST INDIANAPOLIS IN 46260 3172809566 159803 INDIANA UNIVERSITY HEALTH TRANSPLANT 1701 NORTH SENATE BLVD INDIANAPOLIS IN 46206 3179628677 15J200 EVANSVILLE PSYCHIATRIC CHILDREN'S CENTER 3300 E MORGAN AVE EVANSVILLE IN 47715 VANDERBURGH 8124776436 160001 CENTRAL IOWA HEALTHCARE 3 S 4TH AVE MARSHALLTOWN IA 50158 MARSHALL 6417545151 160005 ST ANTHONY REGIONAL HOSPITAL & NURSING HOME 311 SOUTH CLARK STREET CARROLL IA 51401 CARROLL 7127923581 160008 KEOKUK AREA HOSPITAL 1600 MORGAN STREET KEOKUK IA 52632 LEE 3195247150 160013 TRINITY MUSCATINE 1518 MULBERRY AVENUE MUSCATINE IA 52761 MUSCATINE 5632649100 160016 TRINITY REGIONAL MEDICAL CENTER 802 KENYON RD FORT DODGE IA 50501 WEBSTER 5155733101 160024 IOWA LUTHERAN HOSPITAL 700 EAST UNIVERSITY AVENUE DES MOINES IA 50316 POLK 5152635612 160028 CHI HEALTH MERCY COUNCIL BLUFFS 800 MERCY DRIVE COUNCIL BLUFFS IA 51503 POTTAWATTAMIE 7123285000 160029 MERCY HOSPITAL 500 E MARKET STREET IOWA CITY IA 52245 JOHNSON 3193390300 160030 MARY GREELEY MEDICAL CENTER 1111 DUFF AVENUE AMES IA 50010 STORY 5152392011 160032 SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 JASPER 6417921273
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 72 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 160033 GENESIS MEDICAL CENTER‐DAVENPORT 1227 EAST RUSHOLME STREET DAVENPORT IA 52803 SCOTT 5634211000 16003F VA HOSP 3600 30TH STREET DES MOINES IA 50309 POLK 5150000000 160040 SARTORI MEMORIAL HOSPITAL 515 COLLEGE STREET CEDAR FALLS IA 50613 BLACK HAWK 3192683000 160045 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52402 LINN 3193697211 160047 METHODIST JENNIE EDMUNDSON 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 POTTAWATTAMIE 7123966000 16004F VA HOSP 601 HIGHWAY 6 WEST IOWA CITY IA 52240 JOHNSON 5150000000 160057 GREAT RIVER MEDICAL CENTER 1221 SOUTH GEAR AVENUE WEST BURLINGTON IA 52655 DES MOINES 3197681000 160058 UNIVERSITY OF IOWA HOSPITAL & CLINICS 200 HAWKINS DRIVE IOWA CITY IA 52242 JOHNSON 3193561616 16005F VA HOSP WEST PLEASANT ST KNOXVILLE IA 50138 MARION 160064 MERCY MEDICAL CENTER‐NORTH IOWA 1000 FOURTH STREET SW MASON CITY IA 50401 CERRO GORDO 6414287000 160067 COVENANT MEDICAL CENTER 3421 WEST NINTH STREET WATERLOO IA 50702 BLACK HAWK 3192728000 160069 MERCY MEDICAL CENTER‐DUBUQUE 250 MERCY DRIVE DUBUQUE IA 52001 DUBUQUE 5635898000 160079 MERCY MEDICAL CENTER ‐ CEDAR RAPIDS 701 10TH STREET SE CEDAR RAPIDS IA 52403 LINN 3193986011 160080 MERCY MEDICAL CENTER‐CLINTON 1410 NORTH 4TH STREET CLINTON IA 52732 CLINTON 5632445555 160082 IOWA METHODIST MEDICAL CENTER 1200 PLEASANT STREET DES MOINES IA 50309 POLK 5152416212 160083 MERCY MEDICAL CENTER‐DES MOINES 1111 6TH AVE DES MOINES IA 50314 POLK 5152473121 160089 OTTUMWA REGIONAL HEALTH CENTER 1001 E PENNSYLVANIA OTTUMWA IA 52501 WAPELLO 6416827511 160101 BROADLAWNS MEDICAL CENTER 1801 HICKMAN ROAD DES MOINES IA 50314 POLK 5152822200 160104 TRINITY BETTENDORF 4500 UTICA RIDGE ROAD BETTENDORF IA 52722 SCOTT 5637425000 160110 ALLEN HOSPITAL 1825 LOGAN AVENUE WATERLOO IA 50703 BLACK HAWK 3192353941 160112 SPENCER MUNICIPAL HOSPITAL 1200 1ST AVENUE EAST SPENCER IA 51301 CLAY 7122648300 160117 FINLEY HOSPITAL 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 DUBUQUE 5635821881 160122 FORT MADISON COMMUNITY HOSPITAL 5445 AVE OFORT MADISON IA 52627 LEE 3193726530 160124 LAKES REGIONAL HEALTHCARE 2301 HIGHWAY 71 SPIRIT LAKE IA 51360 DICKINSON 7123361230 160146 ST LUKES REGIONAL MEDICAL CENTER 2720 STONE PARK BOULEVARD SIOUX CITY IA 51104 WOODBURY 7122793500 160147 GRINNELL REGIONAL MEDICAL CENTER 210 FOURTH AVENUE GRINNELL IA 50112 POWESHIEK 6412367511 160153 MERCY MEDICAL CENTER‐SIOUX CITY 801 5TH ST SIOUX CITY IA 51101 WOODBURY 7122792010 16016E IOWA MEDICAL AND CLASSIFICATION CENTER HIGHWAY 965 PO BOX A OAKDALE IA 52319 JONES 3196264417 161300 BAUM HARMON MERCY HOSPITAL 255 N WELCH AVENUE PRIMGHAR IA 51245 O'BRIEN 7129572300 161301 IOWA SPECIALTY HOSPITAL ‐ BELMOND 403 FIRST STREET SE BELMOND IA 50421 WRIGHT 6414443223
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 73 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 161302 IOWA SPECIALTY HOSPITAL‐CLARION 1316 SOUTH MAIN STREET CLARION IA 50525 WRIGHT 5155322811 161303 GRUNDY COUNTY MEMORIAL HOSPITAL 201 EAST J AVENUE GRUNDY CENTER IA 50638 GRUNDY 3198245421 161304 CHI HEALTH ‐ MERCY CORNING 603 ROSARY DRIVE CORNING IA 50841 ADAMS 6413223121 161305 POCAHONTAS COMMUNITY HOSPITAL 606 N W 7TH STREET POCAHONTAS IA 50574 POCAHONTAS 7123353501 161306 JONES REGIONAL MEDICAL CENTER 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 JONES 3194626131 161307 HANCOCK COUNTY HEALTH SYSTEM 532 1ST ST NW BRITT IA 50423 HANCOCK 6418435000 161308 FRANKLIN GENERAL HOSPITAL 1720 CENTRAL AVENUE EAST HAMPTON IA 50441 FRANKLIN 6414565000 161309 CHI HEALTH MISSOURI VALLEY 631 N 8TH ST MISSOURI VALLEY IA 51555 HARRISON 7126422784 161310 ADAIR COUNTY MEMORIAL HOSPITAL 609 SE KENT GREENFIELD IA 50849 ADAIR 6417432123 161311 HAWARDEN REGIONAL HEALTHCARE 1111 11TH STREET HAWARDEN IA 51023 SIOUX 7125513100 161312 GUTTENBERG MUNICIPAL HOSPITAL 200 MAIN STREET GUTTENBERG IA 52052 CLAYTON 5632521121 161313 GENESIS MEDICAL CENTER‐DEWITT 1118 11TH STREET DEWITT IA 52742 CLINTON 5636594200 161314 GUTHRIE COUNTY HOSPITAL 710 NORTH 12TH STREET GUTHRIE CENTER IA 50115 GUTHRIE 6413322201 161315 KEOKUK COUNTY HEALTH CENTER 23019 HIGHWAY 149 SIGOURNEY IA 52591 KEOKUK 6416222720 161316 GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS 112 JEFFERSON STREET WEST UNION IA 52175 FAYETTE 5634223811
161317 MARENGO MEMORIAL HOSPITAL 300 W MAY ST MARENGO IA 52301 IOWA 3196425543 161318 VETERANS MEMORIAL HOSPITAL 40 1ST STREET SE WAUKON IA 52172 ALLAMAKEE 5635683411 161319 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON STREET NW ELKADER IA 52043 CLAYTON 5632457000 161320 COMMUNITY MEMORIAL HOSPITAL MEDICAL CENTER 909 WEST FIRST STREET SUMNER IA 50674 BREMER 5635783275
161321 SANFORD ROCK RAPIDS MEDICAL CENTER 801 SOUTH GREENE STREET ROCK RAPIDS IA 51246 LYON 7124722591 161322 DALLAS COUNTY HOSPITAL 610 TENTH STREET PERRY IA 50220 DALLAS 5154653547 161323 MITCHELL COUNTY REGIONAL HEALTH 616 NORTH EIGHTH STREET OSAGE IA 50461 MITCHELL 6417326000 161324 GEORGE C GRAPE COMMUNITY HOSPITAL 2959 US HIGHWAY 275 HAMBURG IA 51640 FREMONT 7123821515 161325 GREENE COUNTY MEDICAL CENTER 1000 WEST LINCOLNWAY JEFFERSON IA 50129 GREENE 5153862114 161326 MADISON COUNTY MEMORIAL HOSPITAL 300 WEST HUTCHINGS STREET WINTERSET IA 50273 MADISON 5154622373 161327 DAVIS COUNTY HOSPITAL 509 NORTH MADISON STREET BLOOMFIELD IA 52537 DAVIS 6416642145 161328 REGIONAL HEALTH SERVICES OF HOWARD COUNTY 235 8TH AVENUE WEST CRESCO IA 52136 HOWARD 5635472101 161329 JACKSON COUNTY REGIONAL HEALTH CENTER 700 W GROVE ST MAQUOKETA IA 52060 JACKSON 5636522474 161330 AUDUBON COUNTY MEMORIAL HOSPITAL 515 PACIFIC STREET AUDUBON IA 50025 AUDUBON 7125632611
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 74 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 161331 MERCY MEDICAL CENTER‐NEW HAMPTON 308 NORTH MAPLE AVENUE NEW HAMPTON IA 50659 CHICKASAW 6413944121 161332 MANNING REGIONAL HEALTHCARE CENTER 1550 SIXTH STREET MANNING IA 51455 CARROLL 7126552072 161333 STORY COUNTY HOSPITAL 640 SOUTH 19TH STREET NEVADA IA 50201 STORY 5153822111 161334 HUMBOLDT COUNTY MEMORIAL HOSPITAL 1000 NORTH 15TH STREET HUMBOLDT IA 50548 HUMBOLDT 5153324200 161335 BUCHANAN COUNTY HEALTH CENTER 1600 FIRST ST EAST INDEPENDENCE IA 50644 BUCHANAN 3193320999 161336 HEGG MEMORIAL HEALTH CENTER 1202 21ST AVENUE ROCK VALLEY IA 51247 SIOUX 7124768000 161337 VAN BUREN COUNTY HOSPITAL 304 FRANKLIN STREET KEOSAUQUA IA 52565 VAN BUREN 3192933171 161338 MERCY HOSPITAL OF FRANCISCAN SISTERS‐OELWEIN 201 EIGHTH AVENUE SE OELWEIN IA 50662 FAYETTE 3192836000 161339 WAVERLY HEALTH CENTER 312 9TH STREET SW WAVERLY IA 50677 BREMER 3193524120 161340 DECATUR COUNTY HOSPITAL 1405 NW CHURCH STREET LEON IA 50144 DECATUR 6414464871 161341 LUCAS COUNTY HEALTH CENTER 1200 NORTH 7TH STREET CHARITON IA 50049 LUCAS 6417743000 161342 MONROE COUNTY HOSPITAL 6580 165TH STREET ALBIA IA 52531 MONROE 6419322134 161343 REGIONAL MEDICAL CENTER 709 W MAIN STREET MANCHESTER IA 52057 DELAWARE 5639273232 161344 WASHINGTON COUNTY HOSPITAL AND CLINICS 400 EAST POLK STREET WASHINGTON IA 52353 WASHINGTON 3196535481 161345 OSCEOLA COMMUNITY HOSPITAL 600 9TH AVENUE NORTH SIBLEY IA 51249 OSCEOLA 7127542574 161346 SIOUX CENTER HEALTH 1101 9TH STREET SE SIOUX CENTER IA 51250 SIOUX 7127221271 161347 FLOYD COUNTY MEDICAL CENTER 800 11TH ST CHARLES CITY IA 50616 FLOYD 6412286830 161348 CLARKE COUNTY HOSPITAL 800 S FILLMORE ST OSCEOLA IA 50213 CLARKE 6413422184 161349 VIRGINIA GAY HOSPITAL 502 NORTH 9TH AVENUE VINTON IA 52349 BENTON 3194726200 161350 STEWART MEMORIAL COMMUNITY HOSPITAL 1301 WEST MAIN STREET LAKE CITY IA 51449 CALHOUN 7124643171 161351 AVERA HOLY FAMILY HOSPITAL 826 NORTH 8TH STREET ESTHERVILLE IA 51334 EMMET 7123622631 161352 CLARINDA REGIONAL HEALTH CENTER 220 ESSIE DAVISON DRIVE CLARINDA IA 51632 PAGE 7125422176 161353 KOSSUTH REGIONAL HEALTH CENTER 1515 SOUTH PHILLIPS STREET ALGONA IA 50511 KOSSUTH 5152952451 161354 HORN MEMORIAL HOSPITAL 701 E 2ND ST IDA GROVE IA 51445 IDA 7123643311 161355 KNOXVILLE HOSPITAL & CLINICS 1002 SOUTH LINCOLN STREET KNOXVILLE IA 50138 MARION 6418422151 161356 HENRY COUNTY HEALTH CENTER 407 S WHITE ST MOUNT PLEASANT IA 52641 HENRY 3193853141 161357 PALO ALTO COUNTY HOSPITAL 3201 1ST STREET EMMETSBURG IA 50536 PALO ALTO 7128525500 161358 WAYNE COUNTY HOSPITAL 417 SOUTH EAST STREET CORYDON IA 50060 WAYNE 6418722260 161359 BURGESS HEALTH CENTER 1600 DIAMOND STREET ONAWA IA 51040 MONONA 7124232311 161360 ORANGE CITY AREA HEALTH SYSTEM 1000 LINCOLN CIRCLE SE ORANGE CITY IA 51041 SIOUX 7127374984
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 75 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 161361 VAN DIEST MEDICAL CENTER 2350 HOSPITAL DRIVE WEBSTER CITY IA 50595 HAMILTON 5158329400 161362 CHEROKEE REGIONAL MEDICAL CENTER 300 SIOUX VALLEY DRIVE CHEROKEE IA 51012 CHEROKEE 7122255101 161363 MONTGOMERY COUNTY MEMORIAL HOSPITAL 2301 EASTERN AVENUE RED OAK IA 51566 MONTGOMERY 7126237000 161364 JEFFERSON COUNTY HEALTH CENTER 2000 S MAIN FAIRFIELD IA 52556 JEFFERSON 6414724111 161365 GREATER REGIONAL MEDICAL CENTER 1700 WEST TOWNLINE ROAD CRESTON IA 50801 UNION 6417827091 161366 SHENANDOAH MEDICAL CENTER 300 PERSHING AVENUE SHENANDOAH IA 51601 PAGE 7122461230 161367 PELLA REGIONAL HEALTH CENTER 404 JEFFERSON STREET PELLA IA 50219 MARION 6416283150 161368 FLOYD VALLEY HOSPITAL 714 LINCOLN ST NE LE MARS IA 51031 PLYMOUTH 7125467871 161369 CRAWFORD COUNTY MEMORIAL HOSPITAL 100 MEDICAL PARKWAY DENISON IA 51442 CRAWFORD 7122652500 161370 LORING HOSPITAL 211 HIGHLAND AVENUE PO BOX 217 SAC CITY IA 50583 SAC 7126627105 161371 WINNESHIEK MEDICAL CENTER 901 MONTGOMERY STREET DECORAH IA 52101 WINNESHIEK 5633822911 161372 BOONE COUNTY HOSPITAL 1015 UNION STREET BOONE IA 50036 BOONE 5154323140 161373 RINGGOLD COUNTY HOSPITAL 504 NORTH CLEVELAND STREET MOUNT AYR IA 50854 RINGGOLD 6414643226 161374 MYRTUE MEDICAL CENTER 1213 GARFIELD AVENUE HARLAN IA 51537 SHELBY 7127555161 161375 BUENA VISTA REGIONAL MEDICAL CENTER 1525 WEST 5TH STREET STORM LAKE IA 50588 BUENA VISTA 7127324030 161376 CASS COUNTY MEMORIAL HOSPITAL 1501 EAST TENTH STREET ATLANTIC IA 50022 CASS 7122433250 161377 MERCY MEDICAL CENTER‐CENTERVILLE ONE ST JOSEPH'S DRIVE CENTERVILLE IA 52544 APPANOOSE 6414374111 161378 MERCY MEDICAL CENTER‐DYERSVILLE 1111 3RD STREET SW DYERSVILLE IA 52040 DUBUQUE 5638757101 161379 MAHASKA HEALTH PARTNERSHIP 1229 C AVENUE EAST OSKALOOSA IA 52577 MAHASKA 6416723100 161380 HANSEN FAMILY HOSPITAL 920 SOUTH OAK STREET IOWA FALLS IA 50126 HARDIN 6416484631 161381 SANFORD SHELDON MEDICAL CENTER 118 NORTH 7TH AVENUE SHELDON IA 51201 O'BRIEN 7123245041 162001 SELECT SPECIALTY HOSPITAL ‐ QUAD CITIES 1111 WEST KIMBERLY ROAD DAVENPORT IA 52806 SCOTT 5634682000 162002 CONTINUING CARE HOSPITAL 1026 A AVENUE NORTHEAST SIXTH FLOOR CEDAR RAPIDS IA 52402 LINN 3193698142 162003 SELECT SPECIALTY HOSPITAL ‐ DES MOINES 1111 6TH AVENUE, 4TH FLOOR MAIN DES MOINES IA 50314 POLK 5152474400 164002 MENTAL HEALTH INSTITUTE 1251 NORTH CEDAR LOOP CHEROKEE IA 51012 CHEROKEE 7122252594 164003 MENTAL HEALTH INSTITUTE 2277 IOWA AVENUE INDEPENDENCE IA 50644 BUCHANAN 3193342583 169800 IOWA METHODIST MEDICAL CENTER TRANSPLANT CENTER 1200 PLEASANT STREET DES MOINES IA 50309 POLK 5152416212
169801 MERCY HOSPITAL MEDICAL CENTER ‐ TRANSPLANT 1111 SIXTH AVE DES MOINES IA 50314 POLK 5152474261 169802 THE UNIVERSITY OF IOWA HOSPITALS AND CLINICS 200 HAWKINS DRIVE IOWA CITY IA 52242 JOHNSON 3193560537
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 76 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 170006 VIA CHRISTI HOSPITAL PITTSBURG INC 1 MT CARMEL WAY PITTSBURG KS 66762 CRAWFORD 6202316100 170009 SAINT JOHN HOSPITAL 3500 SOUTH 4TH STREET LEAVENWORTH KS 66048 LEAVENWORTH 9136806000 170012 SALINA REGIONAL HEALTH CENTER 400 SOUTH SANTA FE AVENUE SALINA KS 67401 SALINE 7854527000 170013 HAYS MEDICAL CENTER 2220 CANTERBURY DRIVE HAYS KS 67601 ELLIS 7856235000 170014 RANSOM MEMORIAL HOSPITAL 1301 S MAIN STREET OTTAWA KS 66067 FRANKLIN 7852298200 170016 ST FRANCIS HEALTH CENTER INC 1700 SW 7TH STREET TOPEKA KS 66606 SHAWNEE 7852958000 170017 SUSAN B ALLEN MEMORIAL HOSPITAL 720 W CENTRAL ST EL DORADO KS 67042 BUTLER 3163224557 17001F MUNSON ARMY HOSP FORT LEAVENWORTH KS 66027 LEAVENWORTH 170020 HUTCHINSON REGIONAL MEDICAL CENTER INC 1701 E 23RD AVENUE HUTCHINSON KS 67502 RENO 6206652001 170022 ATCHISON HOSPITAL 1301 NORTH SECOND STREET ATCHISON KS 66002 ATCHISON 9133676600 170023 ST CATHERINE HOSPITAL 401 EAST SPRUCE GARDEN CITY KS 67846 FINNEY 6202722222 170027 PRATT REGIONAL MEDICAL CENTER 200 COMMODORE ST PRATT KS 67124 PRATT 6204501160 17002F US ARMY HOSP FORT RILEY KS 66442 GEARY 170039 SUMNER REGIONAL MEDICAL CENTER 1323 NORTH A STREET WELLINGTON KS 67152 SUMNER 6203267451 17003F US PENITENTIARY HOSP LEAVENWORTH KS 66048 LEAVENWORTH 170040 UNIVERSITY OF KANSAS HOSPITAL 3901 RAINBOW BLVD KANSAS CITY KS 66103 9135887332 170049 OLATHE MEDICAL CENTER 20333 WEST 151ST STREET OLATHE KS 66061 JOHNSON 9137914200 170058 MERCY HOSPITAL‐FORT SCOTT 401 WOODLAND HILLS BLVD FORT SCOTT KS 66701 BOURBON 6202237057 17005F VA HOSP 2200 GAGE BLVD TOPEKA KS 66622 SHAWNEE 170068 SOUTHWEST MEDICAL CENTER 315 WEST 15TH STREET LIBERAL KS 67901 SEWARD 6206296291 17006F VA HOSP WADSWORTH LEAVENWORTH KS 66048 LEAVENWORTH 170074 GEARY COMMUNITY HOSPITAL 1102 ST MARY'S ROAD JUNCTION CITY KS 66441 GEARY 7852384131 170075 MERCY HOSPITAL 218 E PACK ST MOUNDRIDGE KS 67107 MCPHERSON 6203456391 17007F US AIR FORCE HOSP MCCONNELL AFB WICHITA KS 67221 SEDGWICK 170086 STORMONT VAIL HOSPITAL 1500 SW 10TH AVENUE TOPEKA KS 66604 SHAWNEE 7853546121 17008F VA HOSP 5500 E KELLOGG ST WICHITA KS 67218 SEDGWICK 170094 COFFEY COUNTY HOSPITAL 801 NORTH 4TH STREET BURLINGTON KS 66839 COFFEY 6203642121 170103 NEWTON MEDICAL CENTER 600 MEDICAL CENTER DRIVE NEWTON KS 67114 HARVEY 3162832700 170104 SHAWNEE MISSION MEDICAL CENTER 9100 W 74TH STREET SHAWNEE MISSION KS 66204 JOHNSON 9136762151 170105 MCPHERSON HOSPITAL INC 1000 HOSPITAL DRIVE MCPHERSON KS 67460 MCPHERSON 6202412250
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 77 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 170109 MIAMI COUNTY MEDICAL CENTER 2100 BAPTISTE DRIVE PAOLA KS 66071 MIAMI 9135574385 170110 BOB WILSON MEMORIAL GRANT COUNTY HOSPITAL 415 N MAIN STREET ULYSSES KS 67880 GRANT 6203561266 170120 LABETTE HEALTH 1902 SOUTH US HWY 59 PARSONS KS 67357 LABETTE 6204214880 170122 VIA CHRISTI HOSPITALS WICHITA, INC 929 NORTH ST FRANCIS STREET WICHITA KS 67214 SEDGWICK 3162685000 170123 WESLEY MEDICAL CENTER 550 N HILLSIDE STREET WICHITA KS 67214 SEDGWICK 3169622000 170133 SAINT LUKE'S CUSHING HOSPITAL 711 MARSHALL STREET LEAVENWORTH KS 66048 LEAVENWORTH 9136841102 170137 LAWRENCE MEMORIAL HOSPITAL 325 MAINE STREET LAWRENCE KS 66044 DOUGLAS 7855056100 170142 VIA CHRISTI HOSPITAL MANHATTAN, INC 1823 COLLEGE AVE MANHATTAN KS 66502 RILEY 7857762831 170145 COFFEYVILLE REGIONAL MEDICAL CENTER 1400 W 4TH ST COFFEYVILLE KS 67337 MONTGOMERY 6202511200 170146 PROVIDENCE MEDICAL CENTER 8929 PARALLEL PARKWAY KANSAS CITY KS 66112 9135964000 170150 SOUTH CENTRAL KS MED CENTER 6401 PATTERSON PARKWAY ARKANSAS CITY KS 67005 COWLEY 6204422500 170166 MORTON COUNTY HOSPITAL 445 N HILLTOP ELKHART KS 67950 MORTON 6206972141 170175 WESTERN PLAINS MEDICAL COMPLEX 3001 AVENUE ADODGE CITY KS 67801 FORD 6202258400 170176 OVERLAND PARK REG MED CTR 10500 QUIVIRA ROAD OVERLAND PARK KS 66215 JOHNSON 9135415000 170182 MENORAH MEDICAL CENTER 5721 WEST 119TH STREET OVERLAND PARK KS 66209 JOHNSON 9134986773 170183 KANSAS SURGERY & RECOVERY CENTER 2770 NORTH WEBB ROAD WICHITA KS 67226 SEDGWICK 3166340090 170185 SAINT LUKE'S SOUTH HOSPITAL 12300 METCALF AVENUE OVERLAND PARK KS 66213 JOHNSON 9133177904 170186 KANSAS HEART HOSPITAL 3601 NORTH WEBB ROAD WICHITA KS 67226 SEDGWICK 3166305000 170187 SALINA SURGICAL HOSPITAL 401 SOUTH SANTA FE AVENUE SALINA KS 67401 SALINE 7858270610 170188 KANSAS CITY ORTHOPAEDIC INSTITUTE 3651 COLLEGE BLVD LEAWOOD KS 66211 JOHNSON 9133197633 170190 MANHATTAN SURGICAL HOSPITAL LLC 1829 COLLEGE AVENUE MANHATTAN KS 66502 RILEY 7857765100 170191 GREAT BEND REGIONAL HOSPITAL 514 CLEVELAND STREET GREAT BEND KS 67530 BARTON 6207928833 170194 DOCTORS HOSPITAL LLC 4901 COLLEGE BLVD LEAWOOD KS 66211 JOHNSON 9135291801 170196 KANSAS SPINE & SPECIALTY HOSPITAL, LLC 3333 NORTH WEBB ROAD WICHITA KS 67226 SEDGWICK 3164625326 170197 KANSAS MEDICAL CENTER LLC 1124 WEST 21ST STREET ANDOVER KS 67002 BUTLER 3163004000 170198 SUMMIT SURGICAL, LLC 1818 EAST 23RD AVENUE HUTCHINSON KS 67502 RENO 6206626000 170199 MINIMALLY INVASIVE SURGERY HOSPITAL 11217 LAKEVIEW AVENUE LENEXA KS 66219 JOHNSON 9133227401 170200 VIA CHRISTI HOSPITAL WICHITA ST TERESA, INC 14800 WEST ST TERESA WICHITA KS 67235 SEDGWICK 3167967800 170201 BLUE VALLEY HOSPITAL, INC 12850 METCALF AVENUE OVERLAND PARK KS 66213 JOHNSON 9132202866 170203 PREMIER SURGICAL INSTITUTE 1619 K 66 GALENA KS 66739 CHEROKEE 6207831732
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 78 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 171300 GRISELL MEMORIAL HOSPITAL 210 SOUTH VERMONT AVENUE RANSOM KS 67572 NESS 7857312231 171301 ELLINWOOD DISTRICT HOSPITAL 605 N MAIN STREET ELLINWOOD KS 67526 BARTON 6205642548 171302 OSWEGO COMMUNITY HOSPITAL 800 BARKER DRIVE OSWEGO KS 67356 LABETTE 6207952921 171303 LANE COUNTY HOSPITAL 235 WEST VINE PO BOX 969 DIGHTON KS 67839 LANE 6203975321 171304 ASHLAND HEALTH CENTER 709 OAK STREET ASHLAND KS 67831 CLARK 6206352241 171306 WICHITA COUNTY HEALTH CENTER 211 E EARL STREET LEOTI KS 67861 WICHITA 6203752233 171307 RAWLINS COUNTY HEALTH CENTER 707 GRANT ST ATWOOD KS 67730 RAWLINS 7856263211 171308 MERCY HOSPITAL COLUMBUS 220 N PENNSYLVANIA AVENUE COLUMBUS KS 66725 CHEROKEE 6204292545 171309 JEWELL COUNTY HOSPITAL 100 CRESTVUE AVE MANKATO KS 66956 JEWELL 7853783137 171310 CHEYENNE COUNTY HOSPITAL 210 WEST 1ST STREET ST FRANCIS KS 67756 CHEYENNE 7853322104 171311 ROOKS COUNTY HEALTH CENTER 1210 NORTH WASHINGTON PLAINVILLE KS 67663 ROOKS 7854344553 171312 COMANCHE COUNTY HOSPITAL 2ND & FRISCO STREET COLDWATER KS 67029 COMANCHE 6205822144 171313 KEARNY COUNTY HOSPITAL 500 THORPE STREET LAKIN KS 67860 KEARNY 6203557111 171314 FW HUSTON MEDICAL CENTER 408 DELAWARE STREET WINCHESTER KS 66097 JEFFERSON 9137744340 171315 NEMAHA VALLEY COMMUNITY HOSPITAL 1600 COMMUNITY DR SENECA KS 66538 NEMAHA 7853366181 171316 ANDERSON COUNTY HOSPITAL 421 S MAPLE GARNETT KS 66032 ANDERSON 7852044000 171317 EDWARDS COUNTY HOSPITAL 620 WEST EIGHTH STREET KINSLEY KS 67547 EDWARDS 6206593621 171318 SEDAN CITY HOSPITAL 300 NORTH STREET SEDAN KS 67361 CHAUTAUQUA 6207253115 171319 HOLTON COMMUNITY HOSPITAL 1110 COLUMBINE DRIVE HOLTON KS 66436 JACKSON 7853642116 171320 HORTON COMMUNITY HOSPITAL 240 WEST 18TH STREET HORTON KS 66439 BROWN 7854862642 171321 MEADE DISTRICT HOSPITAL 510 EAST CARTHAGE MEADE KS 67864 MEADE 6208732141 171322 HAMILTON COUNTY HOSPITAL 700 NORTH HUSER SYRACUSE KS 67878 HAMILTON 6203847461 171323 STAFFORD COUNTY HOSPITAL 502 S BUCKEYE STAFFORD KS 67578 STAFFORD 6202345221 171324 SATANTA DISTRICT HOSPITAL CHEYENNE & APACHE SATANTA KS 67870 HASKELL 6206492761 171325 GRAHAM COUNTY HOSPITAL 304 WEST PROUT STREET HILL CITY KS 67642 GRAHAM 7854212121 171326 LOGAN COUNTY HOSPITAL 211 CHERRY AVENUE OAKLEY KS 67748 LOGAN 7856723211 171327 ELLSWORTH COUNTY MEDICAL CENTER 1604 AYLWARD AVENUE ELLSWORTH KS 67439 ELLSWORTH 7854723111 171328 OTTAWA COUNTY HEALTH CENTER 215 E 8TH STREET MINNEAPOLIS KS 67467 OTTAWA 7853922122 171329 SUMNER COUNTY HOSPITAL DISTRICT NO 1 601 SOUTH OSAGE STREET CALDWELL KS 67022 SUMNER 6208456492 171330 HOSPITAL DISTRICT #1 OF RICE COUNTY 619 SOUTH CLARK AVENUE LYONS KS 67554 RICE 6202575173
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 79 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 171331 KIOWA DISTRICT HOSPITAL 1002 SOUTH 4TH STREET KIOWA KS 67070 BARBER 6208254131 171332 KIOWA COUNTY MEMORIAL HOSPITAL 721 WEST KANSAS GREENSBURG KS 67054 KIOWA 6207233341 171333 CLARA BARTON HOSPITAL 250 W 9TH STREET HOISINGTON KS 67544 BARTON 6206532114 171334 MEDICINE LODGE MEMORIAL HOSPITAL 710 N WALNUT STREET MEDICINE LODGE KS 67104 BARBER 6208863771 171335 STEVENS COUNTY HOSPITAL 1006 S JACKSON HUGOTON KS 67951 STEVENS 6205446178 171336 NESS COUNTY HOSPITAL DISTRICT #2 312 CUSTER STREET NESS CITY KS 67560 NESS 7857982291 171337 WAMEGO HEALTH CENTER 711 GENN DRIVE WAMEGO KS 66547 POTTAWATOMIE 7854562295 171338 SABETHA COMMUNITY HOSPITAL 14TH & OREGON SABETHA KS 66534 NEMAHA 7852842121 171339 GREENWOOD COUNTY HOSPITAL 100 W 16TH STREET EUREKA KS 67045 GREENWOOD 6205837451 171340 HERINGTON MUNICIPAL HOSPITAL 100 E HELEN STREET HERINGTON KS 67449 DICKINSON 7852582207 171341 HIAWATHA COMMUNITY HOSPITAL 300 UTAH STREET HIAWATHA KS 66434 BROWN 7857422131 171342 RUSH COUNTY MEMORIAL HOSPITAL 801 LOCUST ST LA CROSSE KS 67548 RUSH 7852222545 171343 STANTON COUNTY HOSPITAL 404 N CHESTNUT JOHNSON KS 67855 STANTON 6204926250 171344 WILSON MEDICAL CENTER REECE CAMPUS 2600 OTTAWA ROAD NEODESHA KS 66757 WILSON 6203258369 171345 PAWNEE VALLEY COMMUNITY HOSPITAL 923 CARROLL AVENUE LARNED KS 67550 PAWNEE 6202853162 171346 ANTHONY MEDICAL CENTER 1101 EAST SPRING STREET ANTHONY KS 67003 HARPER 6208425111 171347 SHERIDAN COUNTY HOSPITAL 826 18TH STREET HOXIE KS 67740 SHERIDAN 7856753281 171348 NORTON COUNTY HOSPITAL 102 E HOLME STREET NORTON KS 67654 NORTON 7858773351 171349 CLOUD COUNTY HEALTH CENTER 1100 HIGHLAND DRIVE CONCORDIA KS 66901 CLOUD 7852431234 171350 RUSSELL REGIONAL HOSPITAL 200 S MAIN STREET RUSSELL KS 67665 RUSSELL 7854833131 171351 WASHINGTON COUNTY HOSPITAL 304 E 3RD STREET WASHINGTON KS 66968 WASHINGTON 7853252211 171352 DECATUR COUNTY HOSPITAL 810 W COLUMBIA STREET OBERLIN KS 67749 DECATUR 7854752208 171353 PHILLIPS COUNTY HEALTH SYSTEMS 1150 STATE STREET PHILLIPSBURG KS 67661 PHILLIPS 7855435226 171354 COMMUNITY HOSPITAL, ONAGA AND ST MARYS CAMPUS 120 WEST 8TH STREET ONAGA KS 66521 POTTAWATOMIE 7858894272
171355 TREGO COUNTY LEMKE MEMORIAL HOSPITAL 320 THIRTEENTH ST WA KEENEY KS 67672 TREGO 7857432182 171356 ST LUKE HOSPITAL & LIVING CENTER 535 SOUTH FREEBRON MARION KS 66861 MARION 6203822177 171357 HILLSBORO COMMUNITY HOSPITAL 701 S MAIN STREET HILLSBORO KS 67063 MARION 6209473114 171358 LINDSBORG COMMUNITY HOSPITAL 605 W LINCOLN STREET LINDSBORG KS 67456 MCPHERSON 7852273308 171359 GREELEY COUNTY HEALTH SERVICES 506 3RD STREET TRIBUNE KS 67879 GREELEY 6203764221
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 80 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 171360 LINCOLN COUNTY HOSPITAL 624 N SECOND LINCOLN KS 67455 LINCOLN 7855244403 171361 REPUBLIC COUNTY HOSPITAL 2420 G STREET BELLEVILLE KS 66935 REPUBLIC 7855272254 171362 CITIZENS MEDICAL CENTER 100 E COLLEGE DRIVE COLBY KS 67701 THOMAS 7854627511 171363 COMMUNITY MEMORIAL HEALTHCARE, INC 708 N 18TH STREET MARYSVILLE KS 66508 MARSHALL 7855622311 171364 OSBORNE COUNTY MEMORIAL HOSPITAL 424 W NEW HAMPSHIRE STREET OSBORNE KS 67473 OSBORNE 7853462121 171365 HANOVER HOSPITAL 205 S HANOVER STREET HANOVER KS 66945 WASHINGTON 7853372214 171366 HARPER HOSPITAL DISTRICT NO 5 700 WEST 13TH HARPER KS 67058 HARPER 6208967324 171367 GOVE COUNTY MEDICAL CENTER 520 WEST 5TH STREET QUINTER KS 67752 GOVE 7857543341 171368 MINNEOLA DISTRICT HOSPITAL NBR 2 212 MAIN MINNEOLA KS 67865 CLARK 6208854264 171369 HODGEMAN COUNTY HEALTH CENTER 809 BRAMLEY JETMORE KS 67854 HODGEMAN 6203578361 171370 GOODLAND REGIONAL MEDICAL CENTER 220 WEST SECOND STREET GOODLAND KS 67735 SHERMAN 7858903625 171371 CLAY COUNTY MEDICAL CENTER 617 LIBERTY CLAY CENTER KS 67432 CLAY 7856322144 171372 SCOTT COUNTY HOSPITAL 201 ALBERT AVENUE SCOTT CITY KS 67871 SCOTT 6208725811 171373 ALLEN COUNTY REGIONAL HOSPITAL 3066 NORTH KENTUCKY STREET IOLA KS 66749 ALLEN 6203651021 171374 FREDONIA REGIONAL HOSPITAL 1527 MADISON FREDONIA KS 66736 WILSON 6203782121 171375 MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS 400 W 8TH STREET, P O BOX 399 BELOIT KS 67420 MITCHELL 7857382266 171376 GIRARD MEDICAL CENTER 302 NORTH HOSPITAL DRIVE GIRARD KS 66743 CRAWFORD 6207248291 171377 SMITH COUNTY MEMORIAL HOSPITAL 614 SOUTH MAIN STREET SMITH CENTER KS 66967 SMITH 7852826845 171378 KINGMAN COMMUNITY HOSPITAL 750 W AVE D KINGMAN KS 67068 KINGMAN 6205323147 171379 MORRIS COUNTY HOSPITAL 600 N WASHINGTON ST COUNCIL GROVE KS 66846 MORRIS 6207676811 171380 NEOSHO MEMORIAL REGIONAL MEDICAL CENTER 629 SOUTH PLUMMER CHANUTE KS 66720 NEOSHO 6204314000 171381 MEMORIAL HOSPITAL 511 NE 10TH ST ABILENE KS 67410 DICKINSON 7852636610 171382 ATCHISON HOSPITAL 800 RAVIN HILL DRIVE ATCHISON KS 66002 ATCHISON 9133605581 171383 WILLIAM NEWTON HOSPITAL 1300 EAST FIFTH AVENUE WINFIELD KS 67156 COWLEY 6202212300 171384 NEWMAN REGIONAL HEALTH 1201 WEST 12TH AVENUE EMPORIA KS 66801 LYON 6203436800 172003 WICHITA‐AMG SPECIALTY HOSPITAL 8080 E PAWNEE WICHITA KS 67207 SEDGWICK 3166820004 172004 PROMISE HOSPITAL OF OVERLAND PARK 6509 WEST 103RD STREET OVERLAND PARK KS 66212 JOHNSON 9136493701 172005 SELECT SPECIALTY HOSPITAL OF KS CITY 1731 NORTH 90TH STREET KANSAS CITY KS 66112 9137325930 172007 SELECT SPECIALTY HOSPITAL WICHITA 929 NORTH ST FRANCIS, 6TH FLOOR, NORTH TOWER WICHITA KS 67214 SEDGWICK 3169623930 173025 THE KANSAS REHABILITATION HOSPITAL 1504 SW 8TH AVENUE TOPEKA KS 66606 SHAWNEE 7852356600
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 81 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 173026 MID AMERICA REHABILITATION HOSPITAL 5701 W 110TH STREET OVERLAND PARK KS 66211 JOHNSON 9134912410 173027 WESLEY REHABILITATION HOSPITAL 8338 WEST 13TH STREET WICHITA KS 67212 SEDGWICK 3167291121 173028 VIA CHRISTI REHABILITATION HOSPITAL INC 1151 N ROCK ROAD WICHITA KS 67206 SEDGWICK 3166343400 173032 REHABILITATION HOSPITAL OF OVERLAND PARK 5100 INDIAN CREEK PARKWAY OVERLAND PARK KS 66207 JOHNSON 9135441957 173033 MEADOWBROOK REHABILITATION HOSPITAL 427 WEST MAIN STREET GARDNER KS 66030 JOHNSON 9138568747 173300 CHILDREN'S MERCY HOSPITAL KANSAS 5808 W 110TH STREET OVERLAND PARK KS 66211 JOHNSON 9132343000 174006 LARNED STATE HOSPITAL 1301 KS HIGHWAY 264 LARNED KS 67550 PAWNEE 6202854360 174016 PRAIRIE VIEW INC 1901 E FIRST STREET PO BOX 467 NEWTON KS 67114 HARVEY 3162846400 174020 COTTONWOOD SPRINGS LLC 13351 S ARAPAHO DRIVE OLATHE KS 66062 JOHNSON 9133533000 179800 VIA CHRISTI REG MED CTR‐TRANSPLANT UNIT 929 N ST FRANCIS WICHITA KS 67214 SEDGWICK 3162685000 179801 UNIVERSITY OF KANSAS HOSPITAL TRANSPLANT CENTER 3901 RAINBOW BLVD KANSAS CITY KS 66106 9135886064
180001 ST ELIZABETH FT THOMAS 85 NORTH GRAND AVENUE FORT THOMAS KY 41075 CAMPBELL 8595723100 180002 WHITESBURG ARH HOSPITAL 240 HOSPITAL ROAD WHITESBURG KY 41858 LETCHER 6066333500 180004 OWENSBORO HEALTH MUHLENBERG COMMUNITY 440 HOPKINSVILLE STREET GREENVILLE KY 42345 MUHLENBERG 2703388000 HOSPITAL 180005 HIGHLANDS REGIONAL MEDICAL CENTER 5000 KENTUCKY ROUTE 321 PRESTONSBURG KY 41653 FLOYD 6068868511 180009 KING'S DAUGHTERS' MEDICAL CENTER 2201 LEXINGTON AVENUE ASHLAND KY 41101 BOYD 6064084401 180010 SAINT JOSEPH HOSPITAL ONE SAINT JOSEPH DRIVE LEXINGTON KY 40504 8593131000 180011 SAINT JOSEPH LONDON 1001 SAINT JOSEPH LANE LONDON KY 40741 LAUREL 6063306000 180012 HARDIN MEMORIAL HOSPITAL 913 NORTH DIXIE AVENUE ELIZABETHTOWN KY 42701 HARDIN 2707371212 180013 THE MEDICAL CENTER AT BOWLING GREEN 250 PARK STREET BOWLING GREEN KY 42101 WARREN 2707451000 180016 JEWISH HOSPITAL ‐ SHELBYVILLE 727 HOSPITAL DRIVE SHELBYVILLE KY 40065 SHELBY 5026474300 180017 T J SAMSON COMMUNITY HOSPITAL 1301 NORTH RACE STREET GLASGOW KY 42141 BARREN 2706514159 180018 ST CLAIRE REGIONAL MEDICAL CENTER 222 MEDICAL CIRCLE MOREHEAD KY 40351 ROWAN 6067836503 180019 MEADOWVIEW REGIONAL MEDICAL CENTER 989 MEDICAL PARK DRIVE MAYSVILLE KY 41056 MASON 6067595311 180020 MIDDLESBORO APPALACHIAN REGIONAL HEALTHCARE 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 BELL 6062421100 HOSPIT 180021 PINEVILLE COMMUNITY HOSPITAL 850 RIVERVIEW AVENUE PINEVILLE KY 40977 BELL 6063377205 180024 SPRING VIEW HOSPITAL 320 LORETTO ROAD LEBANON KY 40033 MARION 2706925145 180025 FLAGET MEMORIAL HOSPITAL 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 NELSON 5023505000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 82 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 180027 MURRAY‐CALLOWAY COUNTY HOSPITAL 803 POPLAR STREET MURRAY KY 42071 CALLOWAY 2707621100 180029 HAZARD ARH REGIONAL MEDICAL CENTER 100 MEDICAL CENTER DRIVE HAZARD KY 41701 PERRY 6064396600 180035 ST ELIZABETH MEDICAL CENTER NORTH 1 MEDICAL VILLAGE DRIVE EDGEWOOD KY 41017 KENTON 8593012000 180036 OUR LADY OF BELLEFONTE HOSPITAL 1000 SAINT CHRISTOPHER DRIVE ASHLAND KY 41101 BOYD 6068333600 180038 OWENSBORO HEALTH REGIONAL HOSPITAL 1201 PLEASANT VALLEY ROAD OWENSBORO KY 42303 DAVIESS 2704172000 180040 JEWISH HOSPITAL & ST MARY'S HEALTHCARE 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 5025874011 180043 MEMORIAL HOSPITAL 210 MARIE LANGDON DRIVE MANCHESTER KY 40962 CLAY 6065985104 180044 PIKEVILLE MEDICAL CENTER 911 BYPASS ROAD PIKEVILLE KY 41501 PIKE 6062183500 180045 ST ELIZABETH FLORENCE 4900 HOUSTON ROAD FLORENCE KY 41042 BOONE 8592125220 180046 BOURBON COMMUNITY HOSPITAL 9 LINVILLE DRIVE PARIS KY 40361 BOURBON 8599873600 180048 EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER 217 SOUTH THIRD STREET DANVILLE KY 40422 BOYLE 8592392409 180049 BAPTIST HEALTH RICHMOND 801 EASTERN BYPASS RICHMOND KY 40475 MADISON 8596233131 180050 HARLAN ARH HOSPITAL 81 BALL PARK ROAD HARLAN KY 40831 HARLAN 6065738100 180051 JENNIE STUART MEDICAL CENTER 320 WEST 18TH STREET HOPKINSVILLE KY 42240 CHRISTIAN 2708870100 180053 FLEMING COUNTY HOSPITAL 55 FOUNDATION DRIVE FLEMINGSBURG KY 41041 FLEMING 6068492351 180056 METHODIST HOSPITAL 1305 N ELM ST HENDERSON KY 42420 HENDERSON 2708277700 180064 SAINT JOSEPH MOUNT STERLING 225 FALCON DRIVE MOUNT STERLING KY 40353 MONTGOMERY 8594975018 180066 LOGAN MEMORIAL HOSPITAL 1625 NASHVILLE STREET RUSSELLVILLE KY 42276 LOGAN 2707264011 180067 UNIVERSITY OF KENTUCKY HOSPITAL 800 ROSE STREET LEXINGTON KY 40536 8593235211 180069 TUG VALLEY ARH REGIONAL MEDICAL CENTER 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 PIKE 6062371700 18006F LOUISVILLE VA MEDICAL CENTER 800 ZORN AVENUE LOUISVILLE KY 40206 5028953401 180070 TWIN LAKES REGIONAL MEDICAL CENTER 910 WALLACE AVENUE LEITCHFIELD KY 42754 GRAYSON 2702599400 180078 PAUL B HALL REGIONAL MEDICAL CENTER 625 JAMES S TRIMBLE BOULEVARD PAINTSVILLE KY 41240 JOHNSON 6067893511 180079 HARRISON MEMORIAL HOSPITAL 1210 KY HWY 36 E CYNTHIANA KY 41031 HARRISON 8592342300 18007F LEXINGTON VA MEDICAL CENTER 1101 VETERANS DRIVE LEXINGTON KY 40502 8592334511 180080 BAPTIST HEALTH CORBIN ONE TRILLIUM WAY CORBIN KY 40701 KNOX 6065281212 180087 TAYLOR REGIONAL HOSPITAL 1700 OLD LEBANON ROAD CAMPBELLSVILLE KY 42718 TAYLOR 2704653561 180088 NORTON HOSPITAL/NORTON MEDICAL PAVILIONS/KOSAIR 200 EAST CHESTNUT STREET LOUISVILLE KY 40202 5026298000 CH 180092 CLARK REGIONAL MEDICAL CENTER 175 HOSPITAL DRIVE WINCHESTER KY 40391 CLARK 8597378559
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 83 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 180093 BAPTIST HEALTH MADISONVILLE 900 HOSPITAL DRIVE MADISONVILLE KY 42431 HOPKINS 2708255100 180095 CRITTENDEN HEALTH SYSTEM 520 WEST GUM STREET MARION KY 42064 CRITTENDEN 2709655281 180101 GEORGETOWN COMMUNITY HOSPITAL 1140 LEXINGTON ROAD GEORGETOWN KY 40324 SCOTT 5028681100 180102 LOURDES HOSPITAL 1530 LONE OAK ROAD PADUCAH KY 42003 MCCRACKEN 2704442444 180103 BAPTIST HEALTH LEXINGTON 1740 NICHOLASVILLE ROAD LEXINGTON KY 40503 8592606104 180104 BAPTIST HEALTH PADUCAH 2501 KENTUCKY AVENUE PADUCAH KY 42003 MCCRACKEN 2705752100 180105 MONROE COUNTY MEDICAL CENTER 529 CAPP HARLAN ROAD TOMPKINSVILLE KY 42167 MONROE 2704879231 180106 THE MEDICAL CENTER AT ALBANY 723 BURKESVILLE ROAD ALBANY KY 42602 CLINTON 6063876421 180115 ROCKCASTLE REGIONAL HOSPITAL & RESPIRATORY CARE CT 145 NEWCOMB AVENUE MOUNT VERNON KY 40456 ROCKCASTLE 6062562195
180116 JACKSON PURCHASE MEDICAL CENTER 1099 MEDICAL CENTER CIRCLE MAYFIELD KY 42066 GRAVES 2702514585 180124 GREENVIEW REGIONAL HOSPITAL 1801 ASHLEY CIRCLE BOWLING GREEN KY 42104 WARREN 2707931000 180127 FRANKFORT REGIONAL MEDICAL CENTER 299 KINGS DAUGHTERS DRIVE FRANKFORT KY 40601 FRANKLIN 5028755240 180128 THREE RIVERS MEDICAL CENTER 2485 HIGHWAY 644 LOUISA KY 41230 LAWRENCE 6066389451 180130 BAPTIST HEALTH LOUISVILLE 4000 KRESGE WAY LOUISVILLE KY 40207 5028978100 180132 LAKE CUMBERLAND REGIONAL HOSPITAL 305 LANGDON STREET SOMERSET KY 42502 PULASKI 6066797441 180138 BAPTIST HEALTH LA GRANGE 1025 NEW MOODY LANE LA GRANGE KY 40031 OLDHAM 5022225388 180139 KENTUCKY RIVER MEDICAL CENTER 540 JETT DRIVE JACKSON KY 41339 BREATHITT 6066666000 180141 UNIVERSITY OF LOUISVILLE HOSPITAL 530 SOUTH JACKSON STREET LOUISVILLE KY 40202 5025623000 180143 SAINT JOSEPH EAST 150 NORTH EAGLE CREEK DRIVE LEXINGTON KY 40509 8599675000 180149 T J HEALTH COLUMBIA 901 WESTLAKE DRIVE COLUMBIA KY 42728 ADAIR 2703844753 180153 CONTINUECARE HOSPITAL AT BAPTIST HEALTH PADUCAH 2501 KENTUCKY AVENUE, 5TH FLOOR PADUCAH KY 42003 MCCRACKEN 2705752100
181301 MARCUM AND WALLACE MEMORIAL HOSPITAL 60 MERCY COURT IRVINE KY 40336 ESTILL 6067232115 181302 THE JAMES B HAGGIN MEMORIAL HOSPITAL 464 LINDEN AVENUE HARRODSBURG KY 40330 MERCER 8597345441 181304 TRIGG COUNTY HOSPITAL 254 MAIN STREET CADIZ KY 42211 TRIGG 2705223215 181305 SAINT JOSEPH MARTIN 11203 MAIN STREET MARTIN KY 41649 FLOYD 6062856401 181306 METHODIST HOSPITAL UNION COUNTY 4604 US HIGHWAY 60 WEST MORGANFIELD KY 42437 UNION 2703895000 181307 MORGAN COUNTY ARH HOSPITAL 476 LIBERTY ROAD WEST LIBERTY KY 41472 MORGAN 6067433186 181308 BLUEGRASS COMMUNITY HOSPITAL 360 AMSDEN AVENUE VERSAILLES KY 40383 WOODFORD 8598792300 181309 CASEY COUNTY HOSPITAL 187 WOLFORD AVENUE LIBERTY KY 42539 CASEY 6067876275
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 84 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 181310 CARROLL COUNTY MEMORIAL HOSPITAL 309 ELEVENTH STREET CARROLLTON KY 41008 CARROLL 5027324321 181311 ST ELIZABETH GRANT 238 BARNES ROAD WILLIAMSTOWN KY 41097 GRANT 8598248240 181312 ST ELIZABETH OWEN 330 ROLAND AVENUE OWENTON KY 40359 OWEN 5024844656 181314 THE MEDICAL CENTER AT CAVERNA 1501 SOUTH DIXIE STREET HORSE CAVE KY 42749 HART 2707862191 181315 EPHRAIM MCDOWELL FORT LOGAN HOSPITAL 110 METKER TRAIL STANFORD KY 40484 LINCOLN 6063654788 181316 MARY BRECKINRIDGE ARH HOSPITAL 130 KATE IRELAND DRIVE HYDEN KY 41749 LESLIE 6066722901 181317 CUMBERLAND COUNTY HOSPITAL 299 GLASGOW ROAD BURKESVILLE KY 42717 CUMBERLAND 2708642511 181318 THE MEDICAL CENTER AT FRANKLIN 1100 BROOKHAVEN ROAD FRANKLIN KY 42135 SIMPSON 2705984800 181319 BRECKINRIDGE MEMORIAL HOSPITAL 1011 OLD HIGHWAY 60 HARDINSBURG KY 40143 BRECKINRIDGE 2707567000 181320 LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC 131 HOSPITAL DRIVE SALEM KY 42078 LIVINGSTON 2709882299
181321 WAYNE COUNTY HOSPITAL 166 HOSPITAL STREET MONTICELLO KY 42633 WAYNE 6063489343 181322 CALDWELL MEDICAL CENTER 100 MEDICAL CENTER DRIVE PRINCETON KY 42445 CALDWELL 2703650300 181323 OHIO COUNTY HOSPITAL 1211 OLD MAIN STREET HARTFORD KY 42347 OHIO 2702987411 181324 THE MEDICAL CENTER AT SCOTTSVILLE 456 BURNLEY ROAD SCOTTSVILLE KY 42164 ALLEN 2706222800 181325 JANE TODD CRAWFORD HOSPITAL 202‐206 MILBY STREET GREENSBURG KY 42743 GREEN 2709324211 181327 MARSHALL COUNTY HOSPITAL 615 OLD SYMSONIA ROAD BENTON KY 42025 MARSHALL 2705274800 181328 BARBOURVILLE ARH HOSPITAL 80 HOSPITAL DRIVE BARBOURVILLE KY 40906 KNOX 6065464175 181329 SAINT JOSEPH BEREA 305 ESTILL STREET BEREA KY 40403 MADISON 8599866500 181330 RUSSELL COUNTY HOSPITAL 153 DOWELL ROAD RUSSELL SPRINGS KY 42642 RUSSELL 2708664141 181331 MCDOWELL ARH HOSPITAL 9879 KENTUCKY ROUTE 122 MC DOWELL KY 41647 FLOYD 6063773400 182001 KINDRED HOSPITAL LOUISVILLE 1313 SAINT ANTHONY PLACE LOUISVILLE KY 40204 5025877001 182002 CONTINUING CARE HOSP AT ST JOSEPH EAST 150 N EAGLE CREEK DR 5TH FLOOR LEXINGTON KY 40509 8592684800 182003 SELECT SPECIALTY HOSPITAL LEXINGTON 310 SOUTH LIMESTONE STREET 3RD FLOOR LEXINGTON KY 40509 8592267178 182004 SELECT SPECIALTY HOSPITAL‐NORTHERN KENTUCKY 85 NORTH GRAND AVENUE THREE CENTER 3RD FLR CENTER FORT THOMAS KY 41075 CAMPBELL 8595723880
182005 COMMONWEALTH REGIONAL SPECIALTY HOSPITAL 250 PARK DRIVE 5TH FLOOR BOWLING GREEN KY 42101 WARREN 2707966200 182006 CONTINUECARE HOSPITAL AT BAPTIST HEALTH CORBIN ONE TRILLIUM WAY, LOWER LEVEL CORBIN KY 40701 KNOX 6065235150
183026 CARDINAL HILL REHABILITATION HOSPITAL 2050 VERSAILLES ROAD LEXINGTON KY 40504 8592545701 183027 HEALTHSOUTH NORTHERN KENTUCKY REHABILITATION 201 MEDICAL VILLAGE DRIVE EDGEWOOD KY 41017 KENTON 8593412044 HOSPI
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 85 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 183028 HEALTHSOUTH LAKEVIEW REHAB HOSPITAL OF CENTRAL KY 134 HEARTLAND DRIVE ELIZABETHTOWN KY 42701 HARDIN 2707693100
183029 SOUTHERN KENTUCKY REHABILITATION HOSPITAL 1300 CAMPBELL LANE BOWLING GREEN KY 42104 WARREN 2707826900 183030 GATEWAY REHABILITATION HOSPITAL 5940 MERCHANTS STREET FLORENCE KY 41042 BOONE 8594262400 183300 SHRINERS HOSPITAL FOR CHILDREN 1900 RICHMOND ROAD LEXINGTON KY 40502 8592662101 184002 WESTERN STATE HOSPITAL 2400 RUSSELLVILLE ROAD HOPKINSVILLE KY 42240 CHRISTIAN 2708896025 184004 EASTERN STATE HOSPITAL 1350 BULL LEA ROAD LEXINGTON KY 40511 8592468000 184006 NORTHKEY COMMUNITY CARE CHILDREN'S INTENSIVE SERV 502 FARRELL DRIVE COVINGTON KY 41011 KENTON 8595783252
184007 THE BROOK HOSPITAL ‐ DUPONT 1405 BROWNS LANE LOUISVILLE KY 40207 5028960495 184008 THE BROOK HOSPITAL ‐ KMI 8521 LAGRANGE ROAD LOUISVILLE KY 40242 5024266380 184009 THE RIDGE BEHAVIORAL HEALTH SYSTEM 3050 RIO DOSA DRIVE LEXINGTON KY 40509 8592692325 184012 LINCOLN TRAIL BEHAVIORAL HEALTH SYSTEM 3909 S WILSON ROAD RADCLIFF KY 40160 HARDIN 2703519444 184013 RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL 1000 INDUSTRIAL DRIVE OWENSBORO KY 42302 DAVIESS 2706896800 184014 CUMBERLAND HALL 270 WALTON WAY HOPKINSVILLE KY 42240 CHRISTIAN 2708861919 184015 CENTRAL STATE HOSPITAL 10510 LAGRANGE ROAD LOUISVILLE KY 40223 5022537045 184017 RIVENDELL BEHAVIORAL HEALTH SERVICES 1035 PORTER PIKE BOWLING GREEN KY 42103 WARREN 2708431199 189800 JEWISH HOSPITAL AND ST MARY'S HEALTHCARE 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 5025818687 189801 KOSAIR CHILDRENS HOSP/NORTON 231 EAST CHESTNUT ST LOUISVILLE KY 40202 5026292087 189802 UNIVERSITY OF KENTUCKY CHANDLER HOSPITAL 800 ROSE STREET LEXINGTON KY 40536 8593235470 190002 LAFAYETTE GENERAL MEDICAL CENTER 1214 COOLIDGE AVENUE LAFAYETTE LA 70503 LAFAYETTE 3372897991 190004 THIBODAUX REGIONAL MEDICAL CENTER 602 N ACADIA ROAD THIBODAUX LA 70301 LAFOURCHE 9854475500 190005 UNIVERSITY MEDICAL CENTER NEW ORLEANS 2000 CANAL STREET NEW ORLEANS LA 70112 5049033000 190006 UNIVERSITY HOSPITAL & CLINICS 2390 WEST CONGRESS LAFAYETTE LA 70506 LAFAYETTE 3372616000 190007 NATCHITOCHES REGIONAL MEDICAL CENTER 501 KEYSER AVE NATCHITOCHES LA 71457 NATCHITOCHES 3182144200 190008 TERREBONNE GENERAL MEDICAL CENTER 8166 MAIN STREET HOUMA LA 70360 TERREBONNE 9858734141 190011 UNIVERSITY HEALTH CONWAY 4864 JACKSON STREET MONROE LA 71202 OUACHITA 3183307000 190013 WEST CALCASIEU CAMERON HOSPITAL 701 EAST CYPRESS STREET SULPHUR LA 70663 CALCASIEU 3375277034 190014 TECHE REGIONAL MEDICAL CENTER 1125 MARGUERITE STREET MORGAN CITY LA 70380 ST. MARY 9853842440 190015 NORTH OAKS MEDICAL CENTER, L L C 15790 PAUL VEGA MD DRIVE HAMMOND LA 70403 TANGIPAHOA 9853452700 190017 OPELOUSAS GENERAL HEALTH SYSTEM 539 EAST PRUDHOMME STREET OPELOUSAS LA 70570 ST. LANDRY 3379483011
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 86 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 190019 CHRISTUS ST FRANCES CABRINI HOSPITAL 3330 MASONIC DRIVE ALEXANDRIA LA 71301 RAPIDES 3184871122 190020 LANE REGIONAL MEDICAL CENTER 6300 MAIN STREET ZACHARY LA 70791 EAST BATON ROUGE 2256584000 190025 SAVOY MEDICAL CENTER 801 POINCIANA AVENUE MAMOU LA 70554 EVANGELINE 3374685261 190026 RAPIDES REGIONAL MEDICAL CENTER 211 4TH STREET ALEXANDRIA LA 71301 RAPIDES 3187693000 190027 CHRISTUS ST PATRICK HOSPITAL 524 DR MICHAEL DEBAKEY STREET LAKE CHARLES LA 70601 CALCASIEU 3374362511 190034 ABBEVILLE GENERAL HOSPITAL 118 N HOSPITAL DR ABBEVILLE LA 70510 VERMILION 3378935466 190036 OCHSNER MEDICAL CENTER 1516 JEFFERSON HWY NEW ORLEANS LA 70121 JEFFERSON 5048423000 190039 WEST JEFFERSON MEDICAL CENTER 1101 MEDICAL CENTER BLVD MARRERO LA 70072 JEFFERSON 5043475511 190040 SLIDELL MEMORIAL HOSPITAL 1001 GAUSE BLVD SLIDELL LA 70458 ST. TAMMANY 9856432200 190041 CHRISTUS HEALTH SHREVEPORT ‐ BOSSIER 1453 E BERT KOUNS INDUSTRIAL DRIVE SHREVEPORT LA 71105 CADDO 3186815000 190044 ACADIA GENERAL HOSPITAL 1305 CROWLEY RAYNE HIGHWAY CROWLEY LA 70526 ACADIA 3377833222 190045 ST TAMMANY PARISH HOSPITAL 1202 S TYLER STREET COVINGTON LA 70433 ST. TAMMANY 9858984000 190046 TOURO INFIRMARY 1401 FOUCHER STREET NEW ORLEANS LA 70115 5048978247 190050 BEAUREGARD MEMORIAL HOSPITAL 600 S PINE STREET DERIDDER LA 70634 BEAUREGARD 3374627100 190053 JENNINGS AMERICAN LEGION HOSPITAL 1634 ELTON ROAD JENNINGS LA 70546 JEFFERSON DAVIS 3376167000 190054 IBERIA GENERAL HOSPITAL AND MEDICAL CENTER 2315 E MAIN STREET NEW IBERIA LA 70562 IBERIA 3373640441 190060 LAKE CHARLES MEMORIAL HOSPITAL 1701 OAK PARK BLVD LAKE CHARLES LA 70601 CALCASIEU 3374943000 190064 OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER 5000 HENNESSY BLVD BATON ROUGE LA 70808 EAST BATON ROUGE 2257656565 190065 BATON ROUGE GENERAL MEDICAL CENTER 3600 FLORIDA STREET BATON ROUGE LA 70806 EAST BATON ROUGE 2253877767 190079 ST CHARLES PARISH HOSPITAL 1057 PAUL MAILLARD ROAD LULING LA 70070 ST. CHARLES 9857853644 190081 WEST CARROLL MEMORIAL HOSPITAL 706 ROSS STREET OAK GROVE LA 71263 WEST CARROLL 3184283237 190086 NORTHERN LOUISIANA MEDICAL CENTER 401 EAST VAUGHN AVENUE RUSTON LA 71270 LINCOLN 3182542100 190088 SPRINGHILL MEDICAL CENTER 2001 DOCTORS DRIVE SPRINGHILL LA 71075 WEBSTER 3185391000 190090 WINN PARISH MEDICAL CENTER 301 W BOUNDARY STREET WINNFIELD LA 71483 WINN 3186483000 190098 UNIVERSITY HEALTH SHREVEPORT 1541 KINGS HIGHWAY SHREVEPORT LA 71103 CADDO 3186755000 190099 AVOYELLES HOSPITAL 4231 HIGHWAY 1192 MARKSVILLE LA 71351 AVOYELLES 3182538611 190102 OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC 4801 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70508 LAFAYETTE 3374702000
190106 OAKDALE COMMUNITY HOSPITAL 130 N HOSPITAL DR OAKDALE LA 71463 ALLEN 3183353700 190111 WILLIS KNIGHTON MEDICAL CENTER 2600 GREENWOOD ROAD SHREVEPORT LA 71103 CADDO 3182124000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 87 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 190114 CLAIBORNE MEMORIAL MEDICAL CENTER 620 EAST COLLEGE STREET HOMER LA 71040 CLAIBORNE 3189272024 190116 MOREHOUSE GENERAL HOSPITAL 323 W WALNUT BASTROP LA 71220 MOREHOUSE 3182833600 190118 DESOTO REGIONAL HEALTH SYSTEM 207 JEFFERSON STREET MANSFIELD LA 71052 DE SOTO 3188724610 190125 ST FRANCIS MEDICAL CENTER 309 JACKSON STREET MONROE LA 71201 OUACHITA 3189664000 190128 WOMAN'S HOSPITAL 100 WOMAN'S WAY BATON ROUGE LA 70817 EAST BATON ROUGE 2259271300 190133 ALLEN PARISH HOSPITAL 108 6TH AVENUE KINDER LA 70648 ALLEN 3377382527 190140 FRANKLIN MEDICAL CENTER 2106 LOOP ROAD WINNSBORO LA 71295 FRANKLIN 3184359411 190144 MINDEN MEDICAL CENTER NO 1 MEDICAL PLAZA MINDEN LA 71055 WEBSTER 3183772321 190145 LASALLE GENERAL HOSPITAL 187 NINTH ST/HWY 84 WEST JENA LA 71342 LA SALLE 3189929200 190146 EAST JEFFERSON GENERAL HOSPITAL 4200 HOUMA BLVD METAIRIE LA 70006 JEFFERSON 5044544000 190151 RICHARDSON MEDICAL CENTER 254 HIGHWAY 3048 RAYVILLE LA 71269 RICHLAND 3187284181 190160 GLENWOOD REGIONAL MEDICAL CENTER 503 MCMILLAN ROAD WEST MONROE LA 71291 OUACHITA 3183294600 190164 BYRD REGIONAL HOSPITAL 1020 FERTITTA BLVD LEESVILLE LA 71446 VERNON 3372399041 190167 MERCY REGIONAL MEDICAL CENTER 800 E MAIN VILLE PLATTE LA 70586 EVANGELINE 3373635684 190176 TULANE MEDICAL CENTER 1415 TULANE AVE NEW ORLEANS LA 70112 5049881900 190177 LAKEVIEW REGIONAL MEDICAL CENTER 95 JUDGE TANNER BOULEVARD COVINGTON LA 70433 ST. TAMMANY 9858674443 190183 LEONARD J CHABERT MEDICAL CENTER 1978 INDUSTRIAL BLVD HOUMA LA 70363 TERREBONNE 9858731285 190184 CITIZENS MEDICAL CENTER 7939 U S HWY 165 SOUTH COLUMBIA LA 71418 CALDWELL 3186496106 190190 CALDWELL MEMORIAL HOSPITAL, INC 411 MAIN STREET COLUMBIA LA 71418 CALDWELL 3186496111 190199 VILLA FELICIANA MEDICAL COMPLEX 5002 HIGHWAY 10 JACKSON LA 70748 EAST FELICIANA 2256344010 190201 LAKE AREA MEDICAL CENTER 4200 NELSON ROAD LAKE CHARLES LA 70605 CALCASIEU 3374746370 190202 OCHSNER MEDICAL CENTER ‐ BATON ROUGE 17000 MEDICAL CENTER DR BATON ROUGE LA 70816 EAST BATON ROUGE 2257554876 190204 OCHSNER MEDICAL CENTER ‐ NORTHSHORE, L L C 100 MEDICAL CENTER DRIVE SLIDELL LA 70461 ST. TAMMANY 9856465000 190205 WOMEN'S AND CHILDREN'S HOSPITAL 4600 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70508 LAFAYETTE 3375219100 190208 EAST CARROLL PARISH HOSPITAL 336 NORTH HOOD STREET LAKE PROVIDENCE LA 71254 EAST CARROLL 3185594023 190218 SABINE MEDICAL CENTER 240 HIGHLAND DRIVE MANY LA 71449 SABINE 3182561232 190236 WILLIS KNIGHTON BOSSIER HEALTH CENTER 2400 HOSPITAL DR BOSSIER CITY LA 71111 BOSSIER 3182127000 190241 PHYSICIANS MEDICAL CENTER 218 CORPORATE DRIVE HOUMA LA 70360 TERREBONNE 9858531390 190242 ST ELIZABETH HOSPITAL 1125 WEST HIGHWAY 30 GONZALES LA 70737 ASCENSION 2256475000 190245 MONROE SURGICAL HOSPITAL 2408 BROADMOOR BLVD MONROE LA 71201 OUACHITA 3184100002
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 88 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 190246 P & S SURGICAL HOSPITAL 312 GRAMMONT ST SUITE 101 MONROE LA 71201 OUACHITA 3183884040 190250 LOUISIANA HEART HOSPITAL 64030 HIGHWAY 434 LACOMBE LA 70445 ST. TAMMANY 9856407500 190251 SURGICAL SPECIALTY CENTER OF BATON ROUGE 8080 BLUEBONNET BLVD BATON ROUGE LA 70810 EAST BATON ROUGE 2254088080 190255 PARK PLACE SURGICAL HOSPITAL 4811 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70508 LAFAYETTE 3372378119 190256 STERLING SURGICAL HOSPITAL 989 ROBERT BLVD SLIDELL LA 70458 ST. TAMMANY 5046908200 190259 LAFAYETTE SURGICAL SPECIALTY HOSPITAL 1101 KALISTE SALOOM RD LAFAYETTE LA 70508 LAFAYETTE 3377694100 190263 HEART HOSPITAL OF LAFAYETTE 1105 KALISTE SALOOM ROAD LAFAYETTE LA 70508 LAFAYETTE 3375211000 190266 THE SPINE HOSPITAL OF LOUISIANA 10105 PARK ROW CIRCLE, SUITE 250 BATON ROUGE LA 70810 EAST BATON ROUGE 2257639900 190267 FAIRWAY MEDICAL CENTER 67252 INDUSTRY LANE COVINGTON LA 70433 ST. TAMMANY 9858016252 190268 LAFAYETTE GENERAL SURGICAL HOSPITAL 1000 W PINHOOK RD SUITE 100 LAFAYETTE LA 70503 LAFAYETTE 3372898095 190270 SOUTHERN SURGICAL HOSPITAL 1700 W LINDBERG DRIVE SLIDELL LA 70458 ST. TAMMANY 9856410600 190274 OCHSNER MEDICAL CENTER KENNER 180 WEST ESPLANADE AVENUE KENNER LA 70065 JEFFERSON 5044648065 190278 SPECIALISTS HOSPITAL SHREVEPORT 1500 LINE AVENUE SHREVEPORT LA 71101 CADDO 3182133800 190297 DOCTORS HOSPITAL AT DEER CREEK LLC 815 SOUTH 10TH STREET LEESVILLE LA 71446 VERNON 3373925088 190298 CENTRAL LOUISIANA SURGICAL HOSPITAL 651 NORTH BOLTON AVE ALEXANDRIA LA 71301 RAPIDES 3184496400 190300 ST CHARLES SURGICAL HOSPITAL LLC 1717 ST CHARLES AVE NEW ORLEANS LA 70130 5045296600 190302 OMEGA HOSPITAL, LLC 2525 SEVERN AVENUE METAIRIE LA 70002 JEFFERSON 5048494900 190303 CYPRESS POINTE SURGICAL HOSPITAL 42570 SOUTH AIRPORT RD HAMMOND LA 70403 TANGIPAHOA 9855106200 190307 SOUTH CAMERON MEMORIAL HOSPITAL 5360 WEST CREOLE HWY CAMERON LA 70631 CAMERON 3375424111 190308 ST BERNARD PARISH HOSPITAL 8000 WEST JUDGE PEREZ DRIVE CHALMETTE LA 70043 ST. BERNARD 5048269500 190312 OUR LADY OF THE ANGELS HOSPITAL 433 PLAZA STREET BOGALUSA LA 70427 WASHINGTON 9857306700 190313 NEW ORLEANS EAST HOSPITAL 5620 READ BLVD NEW ORLEANS LA 70127 5045926600 19042F US AIR FORCE HOSP ENGLAND AFB ALEXANDRIA LA 71301 RAPIDES 3189999999 19043F VA HOSP ALEXANDRIA LA 71301 RAPIDES 3189999999 19044F US AIR FORCE HOSP BARKSDALE AFB BARKSDALE AFB LA 71110 BOSSIER 3189999999 19045F US PUBLIC HEALTH SERVICE HOSP CARVILLE LA 70721 IBERVILLE 2253333333 19046F US PUBLIC HEALTH SERVICE HOSP 210 STATE ST NEW ORLEANS LA 70118 5049999999 19047F VA HOSP 1601 PERDIDO ST NEW ORLEANS LA 70140 5049999999 19048F VA HOSP 510 E STONER AVE SHREVEPORT LA 71101 CADDO 3189999999 19050F US ARMY HOSP FORT POLK LA 71459 VERNON 3189999999
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 89 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 191300 ST HELENA PARISH HOSPITAL CAH 16874 HIGHWAY 43 GREENSBURG LA 70441 ST. HELENA 2252226111 191301 UNION GENERAL HOSPITAL 901 JAMES AVE FARMERVILLE LA 71241 UNION 3183689751 191302 ST MARTIN HOSPITAL 210 CHAMPAGNE BOULEVARD BREAUX BRIDGE LA 70517 ST. MARTIN 3373322178 191303 ASSUMPTION COMMUNITY HOSPITAL 135 HIGHWAY 402 NAPOLEONVILLE LA 70390 ASSUMPTION 9853693600 191304 NORTH CADDO MEDICAL CENTER 715 SOUTH PINE STREET VIVIAN LA 71082 CADDO 3183753235 191305 ST JAMES PARISH HOSPITAL 1645 LUTCHER AVENUE LUTCHER LA 70071 ST. JAMES 2258695512 191306 WEST FELICIANA PARISH HOSPITAL 5266 COMMERCE STREET SAINT FRANCISVILLE LA 70775 WEST FELICIANA 2256353811 191307 DEQUINCY MEMORIAL HOSPITAL 110 WEST 4TH STREET DEQUINCY LA 70633 CALCASIEU 3377861200 191308 PREVOST MEMORIAL HOSPITAL 301 MEMORIAL DR DONALDSONVILLE LA 70346 ASCENSION 2254737931 191309 HOOD MEMORIAL HOSPITAL 301 W WALNUT STREET AMITE LA 70422 TANGIPAHOA 9857489485 191310 FRANKLIN FOUNDATION HOSPITAL 1097 NORTHWEST BLVD FRANKLIN LA 70538 ST. MARY 3378280760 191311 BUNKIE GENERAL HOSPITAL 427 EVERGREEN STREET BUNKIE LA 71322 AVOYELLES 3183466681 191312 CHRISTUS COUSHATTA HEALTH CARE CENTER 1635 MARVEL STREET COUSHATTA LA 71019 RED RIVER 3189322000 191313 RIVERSIDE MEDICAL CENTER 1900 SOUTH MAIN ST FRANKLINTON LA 70438 WASHINGTON 9857954431 191314 MADISON PARISH HOSPITAL 900 JOHNSON STREET TALLULAH LA 71282 MADISON 3185742374 191315 HARDTNER MEDICAL CENTER 1102 N PINE ROAD OLLA LA 71465 LA SALLE 3184953131 191316 POINTE COUPEE GENERAL HOSPITAL 2202 FALSE RIVER DRIVE NEW ROADS LA 70760 POINTE COUPEE 2253686386 191317 JACKSON PARISH HOSPITAL 165 BEECH SPRINGS ROAD JONESBORO LA 71251 JACKSON 3182594435 191318 RIVERLAND MEDICAL CENTER 1700 WALLACE BLVD FERRIDAY LA 71334 CONCORDIA 3187576551 191319 ACADIA ST LANDRY 810 SOUTH BROADWAY STREET CHURCH POINT LA 70525 ACADIA 3376845435 191320 BIENVILLE MEDICAL CENTER 1175 PINE STREET ARCADIA LA 71001 BIENVILLE 3182634700 191321 LALLIE KEMP MEDICAL CENTER 52579 HIGHWAY 51 SOUTH INDEPENDENCE LA 70443 TANGIPAHOA 9858789421 191322 ABROM KAPLAN MEMORIAL HOSPITAL 1310 WEST SEVENTH STREET KAPLAN LA 70548 VERMILION 3376438300 191323 RICHLAND PARISH HOSPITAL‐DELHI 407 CINCINNATI STREET DELHI LA 71232 RICHLAND 3188785171 191324 OCHSNER ST ANNE GENERAL HOSPITAL 4608 HIGHWAY 1 RACELAND LA 70394 LAFOURCHE 9855378377 191325 LADY OF THE SEA GENERAL HOSPITAL 200 WEST 134TH PLACE CUT OFF LA 70345 LAFOURCHE 9856326401 191326 REEVES MEMORIAL MEDICAL CENTER 409 FIRST STREET BERNICE LA 71222 UNION 3182859066 192004 PROMISE HOSPITAL BATON ROUGE 5130 MANCUSO LANE BATON ROUGE LA 70809 EAST BATON ROUGE 2254909600 192006 CORNERSTONE HOSPITAL OF BOSSIER CITY 4900 MEDICAL DRIVE BOSSIER CITY LA 71112 BOSSIER 3187479500 192007 LOUISIANA CONTINUING CARE HOSPITAL 1101 MEDICAL CENTER BLVD 7TH FLOOR MARRERO LA 70072 JEFFERSON 5043492584
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 90 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 192008 BATON ROUGE ‐ A M G SPECIALTY HOSPITAL 8375 FLORIDA BLVD DENHAM SPRINGS LA 70726 LIVINGSTON 2256652664 192009 KINDRED HOSPITAL NEW ORLEANS 3601 COLISEUM STREET NEW ORLEANS LA 70115 5048991555 192010 PROMISE HOSPITAL OF LOUISIANA, INC 1800 IRVING PLACE SHREVEPORT LA 71101 CADDO 3184254096 192011 LIFECARE HOSPITALS OF SHREVEPORT 9320 LINWOOD AVENUE SHREVEPORT LA 71106 CADDO 3186888504 192012 CHRISTUS DUBUIS HOSPITAL OF ALEXANDRIA 3330 MASONIC DR ALEXANDRIA LA 71301 RAPIDES 3184484938 192013 CORNERSTONE HOSPITAL SOUTHWEST LOUISIANA 703 CYPRESS STREET SULPHUR LA 70663 CALCASIEU 3373106033 192015 OCHSNER EXTENDED CARE HOSPITAL OF KENNER 180 WEST ESPLANADE, FIFTH FLOOR KENNER LA 70065 JEFFERSON 5044648590 192016 SPECIALTY HOSPITAL 309 JACKSON STREET, 7TH FLOOR MONROE LA 71201 OUACHITA 3189664126 192019 MEMORIAL SPECIALTY HOSPITAL 524 DR MICHAEL DEBAKEY DRIVE, 3RD FLOOR LAKE CHARLES LA 70601 CALCASIEU 3374808990 192022 LIFECARE SPECIALTY HOSPITAL OF NORTH LOUISIANA 1401 EZELL STREET RUSTON LA 71270 LINCOLN 3182513126 192023 ST CATHERINE MEMORIAL HOSPITAL 14500 HAYNE BLVD NEW ORLEANS LA 70128 5042103000 192028 PROMISE HOSPITAL OF MISS LOU 209 FRONT STREET VIDALIA LA 71373 CONCORDIA 3183366500 192029 LAFAYETTE ‐ A M G SPECIALTY HOSPITAL 4811 AMBASSADOR CAFFERY PKWY, 4TH FLOOR LAFAYETTE LA 70506 LAFAYETTE 3378399880 192030 ST THERESA SPECIALTY HOSPITAL, LLC 3601 LOYOLA DRIVE KENNER LA 70065 JEFFERSON 5049047561 192031 CORNERSTONE HOSPITAL WEST MONROE 6198 CYPRESS STREET WEST MONROE LA 71291 OUACHITA 3183965600 192032 LOUISIANA EXTENDED CARE HOSPITAL OF LAFAYETTE 1214 COOLIDGE BLVD, 9TH FLOOR LAFAYETTE LA 70503 LAFAYETTE 3372898180 192033 POST ACUTE MEDICAL SPECIALTY HOSPITAL OF LAFAYETTE 204 ENERGY PARKWAY LAFAYETTE LA 70508 LAFAYETTE 3372321905
192034 ST LANDRY EXTENDED CARE HOSPITAL 3983 I‐49 SOUTH SERVICE RD, 2ND FLOOR OPELOUSAS LA 70570 ST. LANDRY 3379485184 192035 LOUISIANA EXTENDED CARE HOSPITAL OF NATCHITOCHES 501 KEYSER AVE 4TH FLOOR NATCHITOCHES LA 71457 NATCHITOCHES 3183542044
192036 POST ACUTE SPECIALTY HOSPITAL OF HAMMOND 42074 VETERANS AVENUE HAMMOND LA 70403 TANGIPAHOA 9859028148 192037 HOUMA ‐ AMG SPECIALTY HOSPITAL 629 DUNN STREET HOUMA LA 70360 TERREBONNE 9852740001 192040 SOUTHEAST REGIONAL MEDICAL CENTER, INC 719 AVENUE G KENTWOOD LA 70444 TANGIPAHOA 9852299193 192041 ZACHARY ‐ A M G SPECIALTY HOSPITAL 4601 MCHUGH ROAD, BLDG B ZACHARY LA 70791 EAST BATON ROUGE 2256831600 192043 RIVERSIDE HOSPITAL OF LOUISIANA INC 211 FOURTH ST FIFTH FLOOR ALEXANDRIA LA 71301 RAPIDES 3187672900 192048 NORTHSHORE SPECIALTY HOSPITAL 20050 CRESTWOOD BLVD COVINGTON LA 70433 ST. TAMMANY 9858757525 192049 PROMISE HOSPITAL OF BATON ROUGE, INC 17000 MEDICAL CENTER DR 3RD FLOOR BATON ROUGE LA 70816 EAST BATON ROUGE 2252365440 192051 COVINGTON ‐ AMG SPECIALTY HOSPITAL 195 HIGHLAND PARK ENTRANCE COVINGTON LA 70433 ST. TAMMANY 9858673977 192052 SPECIALTY HOSPITAL OF WINNFIELD, INC 915 1ST STREET WINNFIELD LA 71483 WINN 3186483523
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 91 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 192055 LOUISIANA EXTENDED CARE HOSPITAL OF WEST MONROE 503 MCMILLIAN ROAD, 3RD FLOOR WEST MONROE LA 71291 OUACHITA 3183294300
193028 BATON ROUGE REHAB HOSPITAL 8595 UNITED PLAZA BLVD BATON ROUGE LA 70809 EAST BATON ROUGE 2259270567 193031 HEALTHSOUTH REHABILITATION HOSPITAL OF ALEXANDRIA 104 NORTH THIRD STREET ALEXANDRIA LA 71301 RAPIDES 3184491370
193044 NORTH OAKS REHABILITATION HOSPITAL, L L C 1900 S MORRISON BLVD HAMMOND LA 70403 TANGIPAHOA 9855427777 193050 TRI PARISH REHABILITATION HOSPITAL L L C 8088 HAWKS RD LEESVILLE LA 71446 VERNON 3374628880 193058 BASTROP REHABILITATION HOSPITAL ‐ MONROE 4310 SOUTH GRAND STREET MONROE LA 71202 OUACHITA 3185568000 193067 REHABILITATION HOSPITAL OF JENNINGS 1 HOSPITAL DRIVE, SUITE 101 JENNINGS LA 70546 JEFFERSON DAVIS 3378215353 193069 STERLINGTON REHABILITATION HOSPITAL 370 W HICKORY STREET BASTROP LA 71220 MOREHOUSE 3182814531 193070 M M O REHABILITATION AND WELLNESS CENTER 59215 RIVER WEST DRIVE PLAQUEMINE LA 70764 IBERVILLE 2256878100 193074 UNITED MEDICAL HEALTHWEST‐NEW ORLEANS 3201 WALL BLVD, STE B GRETNA LA 70056 JEFFERSON 5044335551 193078 SAGE REHABILITATION HOSPITAL 8000 SUMMA AVE BATON ROUGE LA 70809 EAST BATON ROUGE 2258190703 193079 UNITED MEDICAL REHABILITATION HOSPITAL 15717 BELLE DRIVE HAMMOND LA 70403 TANGIPAHOA 9853405998 193080 SPECIALTY REHABILITATION HOSPITAL 1110 RINGGOLD AVENUE COUSHATTA LA 71019 RED RIVER 3189321770 193086 LEESVILLE REHABILITATION HOSPITAL 900 SOUTH SIXTH STREET LEESVILLE LA 71446 VERNON 3373928118 193090 THE NEUROMEDICAL CENTER REHABILITATION HOSPITAL, L 10101 PARK ROWE AVENUE BATON ROUGE LA 70810 EAST BATON ROUGE 2259062999
193092 BETHESDA REHABILITATION HOSPITAL 8225 SUMMA AVE BATON ROUGE LA 70809 EAST BATON ROUGE 2257672034 193093 LAFAYETTE PHYSICAL REHABILITATION HOSPITAL 307 POLLY LANE LAFAYETTE LA 70508 LAFAYETTE 3373141111 193094 PATHWAY REHABILITATION HOSPITAL OF BOSSIER 4900 MEDICAL DRIVE BOSSIER CITY LA 71112 BOSSIER 3188415555 193096 IBERIA REHABILITATION HOSPITAL 532 JEFFERSON TERRACE STREET NEW IBERIA LA 70560 IBERIA 3373646923 193097 COVINGTON ‐ AMG PHYSICAL REHABILITATION HOSPITAL 5025 KEYSTONE BLVDSUITE 200 COVINGTON LA 70433 ST. TAMMANY 9858880301
193300 CHILDREN'S HOSPITAL 200 HENRY CLAY AVE NEW ORLEANS LA 70118 5048999511 193301 SHRINERS HOSPITALS FOR CHILDREN 3100 SAMFORD AVENUE SHREVEPORT LA 71103 CADDO 3182225704 194007 NORTHLAKE BEHAVIORAL HEALTH SYSTEM 23515 HIGHWAY 190 MANDEVILLE LA 70448 ST. TAMMANY 9856266300 194008 EASTERN LA MENTAL HEALTH SYSTEM 4502 HIGHWAY 951 JACKSON LA 70748 EAST FELICIANA 2256340100 194020 BRENTWOOD HOSPITAL 1006 HIGHLAND AVENUE SHREVEPORT LA 71106 CADDO 3186787500 194022 LONGLEAF HOSPITAL 44 VERSAILLES BLVD ALEXANDRIA LA 71303 RAPIDES 3184455111 194025 CENTRAL LOUISIANA STATE HOSPITAL 242 W SHAMROCK STREET PINEVILLE LA 71361 RAPIDES 3184846200 194031 RIVER OAKS HOSPITAL 1525 RIVER OAKS WEST HARAHAN LA 70123 JEFFERSON 5047341740
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 92 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 194044 VERMILION BEHAVIORAL HEALTH SYSTEMS 2520 N UNIVERSITY AVENUE LAFAYETTE LA 70507 LAFAYETTE 3372345614 194056 COMMUNITY CARE HOSPITAL 1421 GENERAL TAYLOR NEW ORLEANS LA 70115 5048992500 194069 GREENBRIER BEHAVIORAL HEALTH 201 GREENBRIER BLVD COVINGTON LA 70433 ST. TAMMANY 9858932970 194073 OCEANS HOSPITAL OF BROUSSARD 420 ALBERTSONS PARKWAY BROUSSARD LA 70518 LAFAYETTE 3378399008 194074 SERENITY SPRINGS SPECIALTY HOSPITAL 1495 FRAZIER ROAD RUSTON LA 71270 LINCOLN 3182023860 194075 WESTEND HOSPITAL 1530 HIGHWAY 90 WEST JENNINGS LA 70546 JEFFERSON DAVIS 3376168122 194078 OPTIMA SPECIALTY HOSPITAL 1131 RUE DE BELIER LAFAYETTE LA 70506 LAFAYETTE 3379910571 194079 RED RIVER BEHAVIORAL CENTER, LLC 2800 MELROSE AVENUE BOSSIER CITY LA 71111 BOSSIER 3185492099 194080 BEACON BEHAVIORAL HOSPITAL ‐ NORTHSHORE, INC 64026 HWY 434, SUITE 300 (3RD FLOOR) LACOMBE LA 70445 ST. TAMMANY 9858820226 194081 OCEANS BEHAVIORAL HOSPITAL OF DERIDDER 1420 BLANKENSHIP DRIVE DERIDDER LA 70634 BEAUREGARD 3374609472 194082 JENNINGS SENIOR CARE HOSPITAL 1 HOSPITAL DRIVE, SUITE 201 JENNINGS LA 70546 JEFFERSON DAVIS 3378241558 194083 LIBERTY HEALTHCARE SYSTEMS, LLC 4673 EUGENE WARE ROAD BASTROP LA 71220 MOREHOUSE 3182812448 194084 BEACON BEHAVIORAL HOSPITAL‐ NEW ORLEANS, INC 14500 HAYNES BLVD NEW ORLEANS LA 70128 5042100460 194085 COMPASS BEHAVIORAL CENTER OF CROWLEY 1526 NORTH AVENUE I CROWLEY LA 70526 ACADIA 3377883380 194086 OCEANS BEHAVIORAL HOSPITAL OF BATON ROUGE 11135 FLORIDA BLVD BATON ROUGE LA 70815 EAST BATON ROUGE 2253567030 194087 ALLEGIANCE HEALTH CENTER OF RUSTON, LLC 1401 EZELL STREET RUSTON LA 71270 LINCOLN 3182558085 194088 ST JAMES BEHAVIORAL HEALTH HOSPITAL, INC 3136 SOUTH ST LANDRY ROAD GONZALES LA 70737 ASCENSION 2256477524 194089 GENESIS BEHAVIORAL HOSPITAL 606 LATIOLAIS ROAD BREAUX BRIDGE LA 70517 ST. MARTIN 3374426254 194090 OCEANS BEHAVIORAL HOSPITAL OF LAKE CHARLES 4250 FIFTH AVENUE LAKE CHARLES LA 70607 CALCASIEU 3374747581 194091 OCEANS BEHAVIORAL HOSPITAL OF KENTWOOD 921 AVENUE G KENTWOOD LA 70444 TANGIPAHOA 9852290717 194094 PHYSICIANS BEHAVIORAL HOSPITAL 2025 DESOTO ST SHREVEPORT LA 71103 CADDO 3185500520 194095 OCEANS BEHAVIORAL HOSPITAL OF OPELOUSAS 1310 HEATHER DRIVE OPELOUSAS LA 70570 ST. LANDRY 3379488820 194096 OCEANS BEHAVIORAL HOSPITAL OF ALEXANDRIA 2621 NORTH BOLTON AVENUE ALEXANDRIA LA 71303 RAPIDES 3184488473 194097 PHOENIX BEHAVIORAL HOSPITAL 2021 CROWLEY RAYNE HIGHWAY RAYNE LA 70578 ACADIA 3377880091 194098 OCEANS BEHAVIORAL HOSPITAL OF GREATER NEW 716 VILLAGE ROAD KENNER LA 70065 JEFFERSON 5044648895 ORLEANS 194100 SEASIDE BEHAVIORAL CENTER 4201 WOODLAND DRIVE NEW ORLEANS LA 70131 5043934223 194102 BEACON BEHAVIORAL HOSPITAL, INC 2471 LOUISIANA AVE LUTCHER LA 70071 ST. JAMES 2252586103 194103 SEASIDE HEALTH SYSTEM 4363 CONVENTION STREET BATON ROUGE LA 70806 EAST BATON ROUGE 2255224076 194105 APOLLO BEHAVIORAL HEALTH HOSPITAL, L L C 7414 SUMRALL DRIVE, SUITE CBATON ROUGE LA 70812 EAST BATON ROUGE 2256632881
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 93 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 194106 COMPASS BEHAVIORAL CENTER OF ALEXANDRIA, INC 6410 MASONIC DRIVE ALEXANDRIA LA 71301 RAPIDES 3184423163 194107 BATON ROUGE BEHAVIORAL HOSPITAL 4040 NORTH BLVD. BATON ROUGE LA 70806 EAST BATON ROUGE 2253008470 194109 COMPASS BEHAVIORAL CENTER OF HOUMA, INC 4701 WEST PARK AVENUE HOUMA LA 70364 TERREBONNE 9858761715 194112 BEACON BEHAVIORAL HOSPITAL ‐ CENTRAL 323 EVERGREEN STREET BUNKIE LA 71322 AVOYELLES 3183463143 199801 TULANE UNIVERSITY HOSPITAL AND CLINIC 1415 TULANE AVE NEW ORLEANS LA 70112 5049885800 199802 OCHSNER FOUNDATION HOSPITAL 1514 JEFFERSON HIGHWAY NEW ORLEANS LA 70121 JEFFERSON 5048423925 199803 CHILDREN'S HOSPITAL 200 HENRY CLAY AVE NEW ORLEANS LA 70118 5048969450 199804 WILLIS‐KNIGHTON MEDICAL CENTER 2600 GREENWOOD ROAD SHREVEPORT LA 71103 CADDO 3182124170 200001 ST JOSEPH HOSPITAL 360 BROADWAY BANGOR ME 04401 PENOBSCOT 2072621000 200008 MERCY HOSPITAL 144 STATE STREET PORTLAND ME 04101 CUMBERLAND 2078793000 200009 MAINE MEDICAL CENTER 22 BRAMHALL ST PORTLAND ME 04102 CUMBERLAND 2076620111 200018 AROOSTOOK MEDICAL CENTER PO BOX 151 PRESQUE ISLE ME 04769 AROOSTOOK 2077684000 200019 SOUTHERN MAINE HEALTH CARE 1 MEDICAL CENTER DRIVE BIDDEFORD ME 04005 YORK 2072837000 200020 YORK HOSPITAL 15 HOSPITAL DRIVE YORK ME 03909 YORK 2073634321 200021 MID COAST HOSPITAL 123 MEDICAL CENTER DRIVE BRUNSWICK ME 04011 CUMBERLAND 2077290181 200024 CENTRAL MAINE MEDICAL CENTER 300 MAIN STREET LEWISTON ME 04240 ANDROSCOGGIN 2077950111 200031 CARY MEDICAL CENTER 163 VAN BUREN RD, SUITE 1 CARIBOU ME 04736 AROOSTOOK 2074983111 200033 EASTERN MAINE MEDICAL CENTER PO BOX 404 BANGOR ME 04401 PENOBSCOT 2079737000 200034 ST MARYS REGIONAL MEDICAL CENTER CAMPUS AVENUE ‐ PO BOX 7291 LEWISTON ME 04240 ANDROSCOGGIN 2077778100 200037 FRANKLIN MEMORIAL HOSPITAL 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 FRANKLIN 2077786031 200039 MAINEGENERAL MEDICAL CENTER 35 MEDICAL CENTER PARKWAY AUGUSTA ME 04330 KENNEBEC 2078721000 20003F VA HOSP TOGUS ME 04330 KENNEBEC 200041 INLAND HOSPITAL 200 KENNEDY MEMORIAL DRIVE WATERVILLE ME 04901 KENNEBEC 2078613012 200050 MAINE COAST MEMORIAL HOSPITAL 50 UNION STREET ELLSWORTH ME 04605 HANCOCK 2076675311 200052 NORTHERN MAINE MEDICAL CENTER 194 E MAIN STREET FORT KENT ME 04743 AROOSTOOK 2078343195 200063 PENOBSCOT BAY MEDICAL CENTER 6 GLEN COVE DRIVE ROCKPORT ME 04856 KNOX 2075968000 201300 BLUE HILL MEMORIAL HOSPITAL 57 WATER STREET BLUE HILL ME 04614 HANCOCK 2073742836 201301 CHARLES A DEAN MEMORIAL HOSPITAL PRITHAM AVENUE PO BOX 1129 GREENVILLE ME 04441 PISCATAQUIS 2076955200 201302 ST ANDREWS HOSPITAL 35 MILES STREET DAMARISCOTTA ME 04543 LINCOLN 2075631234 201303 PENOBSCOT VALLEY HOSPITAL 7 TRANSALPINE ROAD, PO BOX 368 LINCOLN ME 04457 PENOBSCOT 2077943321
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 94 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 201304 MOUNT DESERT ISLAND HOSPITAL 10 WAYMAN LANE, PO BOX 8BAR HARBOR ME 04609 HANCOCK 2072885081 201305 CALAIS REGIONAL HOSPITAL 24 HOSPITAL LANE CALAIS ME 04619 WASHINGTON 2074547521 201306 RUMFORD HOSPITAL 420 FRANKLIN STREET RUMFORD ME 04276 OXFORD 2073691000 201307 MILLINOCKET REGIONAL HOSPITAL 200 SOMERSET STREET MILLINOCKET ME 04462 PENOBSCOT 2077235161 201308 HOULTON REGIONAL HOSPITAL 20 HARTFORD STREET HOULTON ME 04730 AROOSTOOK 2075322900 201309 MAYO REGIONAL HOSPITAL 897 WEST MAIN STREET DOVER FOXCROFT ME 04426 PISCATAQUIS 2075644251 201310 BRIDGTON HOSPITAL 10 HOSPITAL DRIVE BRIDGTON ME 04009 CUMBERLAND 2076476000 201311 DOWN EAST COMMUNITY HOSPITAL 11 HOSPITAL DRIVE MACHIAS ME 04654 WASHINGTON 2072553356 201312 WALDO COUNTY GENERAL HOSPITAL PO BOX 287 BELFAST ME 04915 WALDO 2073382500 201313 SEBASTICOOK VALLEY HEALTH 447 NORTH MAIN STREET PITTSFIELD ME 04967 SOMERSET 2074875141 201314 REDINGTON FAIRVIEW GENERAL HOSPITAL 46 FAIRVIEW AVE PO BOX 468 SKOWHEGAN ME 04976 SOMERSET 2074745121 201315 STEPHENS MEMORIAL HOSPITAL 181 MAIN STREET NORWAY ME 04268 OXFORD 2077435933 203025 HEALTHSOUTH/MAINE MEDICAL CENTER, LLC 335 BRIGHTON AVENUE, UNIT 201 PORTLAND ME 04102 CUMBERLAND 2077754000 204004 DOROTHEA DIX PSYCHIATRIC CENTER 656 STATE STREET BANGOR ME 04401 PENOBSCOT 2079414000 204005 SPRING HARBOR HOSPITAL 123 ANDOVER ROAD WESTBROOK ME 04092 CUMBERLAND 2077612200 204006 ACADIA HOSPITAL, THE 268 STILLWATER AVE BANGOR ME 04401 PENOBSCOT 2079736100 209801 MAINE MEDICAL CENTER ‐TRANSPLANT CENTER 22 BRAMHALL ST PORTLAND ME 04102 CUMBERLAND 2076627181 210001 MERITUS MEDICAL CENTER 11116 MEDICAL CAMPUS ROAD HAGERSTOWN MD 21742 WASHINGTON 2403139500 210002 UNIVERSITY OF MARYLAND MEDICAL CENTER 22 SOUTH GREENE STREET BALTIMORE MD 21201 4103288667 210003 PRINCE GEORGES HOSPITAL CENTER 3001 HOSPITAL DRIVE CHEVERLY MD 20785 PRINCE GEORGE'S 3016182000 210004 HOLY CROSS HOSPITAL 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 MONTGOMERY 3017547000 210005 FREDERICK MEMORIAL HOSPITAL 400 WEST SEVENTH ST FREDERICK MD 21701 FREDERICK 2405663300 210006 UNIVERSITY OF MARYLAND HARFORD MEMORIAL 501 SOUTH UNION AVENUE HAVRE DE GRACE MD 21078 HARFORD 4436433303 HOSPITAL 210008 MERCY MEDICAL CENTER INC 301 SAINT PAUL PLACE BALTIMORE MD 21202 4103329237 210009 JOHNS HOPKINS HOSPITAL, THE 600 NORTH WOLFE STREET BALTIMORE MD 21287 4109559540 210011 SAINT AGNES HOSPITAL 900 CATON AVENUE BALTIMORE MD 21229 4103682101 210012 SINAI HOSPITAL OF BALTIMORE 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 4106015131 210013 BON SECOURS HOSPITAL 2000 W BALTIMORE STREET BALTIMORE MD 21223 4103623000 210015 MEDSTAR FRANKLIN SQUARE MEDICAL CENTER 9000 FRANKLIN SQUARE DRIVE BALTIMORE MD 21237 BALTIMORE 4437777850
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 95 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 210016 ADVENTIST HEALTHCARE WASHINGTON ADVENTIST 7600 CARROLL AVENUE TAKOMA PARK MD 20912 MONTGOMERY 3018915651 HOSPITAL 210017 GARRETT COUNTY MEMORIAL HOSPITAL 251 NORTH FOURTH STREET OAKLAND MD 21550 GARRETT 3015334173 210018 MEDSTAR MONTGOMERY MEDICAL CENTER 18101 PRINCE PHILIP DRIVE OLNEY MD 20832 MONTGOMERY 3017748882 210019 PENINSULA REGIONAL MEDICAL CENTER 100 EAST CARROLL AVENUE SALISBURY MD 21801 WICOMICO 4105437111 21001F US ARMY HOSP ABERDEEN PROVING GROUND ABERDEEN MD 21005 HARFORD 210022 SUBURBAN HOSPITAL 8600 OLD GEORGETOWN ROAD BETHESDA MD 20814 MONTGOMERY 3018962576 210023 ANNE ARUNDEL MEDICAL CENTER 2001 MEDICAL PARKWAY ANNAPOLIS MD 21401 ANNE ARUNDEL 4434811307 210024 MEDSTAR UNION MEMORIAL HOSPITAL 201 EAST UNIVERSITY PARKWAY BALTIMORE MD 21218 4105542227 210026 CHURCH HOSPITAL CORPORATION 100 N BROADWAY BALTIMORE MD 21231 4105228000 210027 WESTERN MARYLAND REGIONAL MEDICAL CENTER 12500 WILLOWBROOK ROAD CUMBERLAND MD 21502 ALLEGANY 2409648001 210028 MEDSTAR SAINT MARY'S HOSPITAL 25500 POINT LOOKOUT ROAD LEONARDTOWN MD 20650 ST. MARY'S 3014756001 210029 JOHNS HOPKINS BAYVIEW MEDICAL CENTER 4940 EASTERN AVENUE BALTIMORE MD 21224 4105500123 210030 UNIVERSITY OF MD SHORE MEDICAL CTR AT 100 BROWN STREET CHESTERTOWN MD 21620 KENT 4107787668 CHESTERTOWN 210032 UNION HOSPITAL OF CECIL COUNTY 106 BOW STREET ELKTON MD 21921 CECIL 4103927009 210033 CARROLL HOSPITAL CENTER 200 MEMORIAL AVENUE WESTMINSTER MD 21157 CARROLL 4108483000 210034 MEDSTAR HARBOR HOSPITAL 3001 SOUTH HANOVER STREET BALTIMORE MD 21225 4103503201 210035 UNIVERSITY OF MD CHARLES REGIONAL MEDICAL CENTER 5 GARRETT AVENUE LA PLATA MD 20646 CHARLES 3016094265
210037 UNIVERSITY OF MD SHORE MEDICAL CENTER AT EASTON 219 SOUTH WASHINGTON STREET EASTON MD 21601 TALBOT 4108221000
210038 UNIVERSITY OF MD MEDICAL CENTER MIDTOWN CAMPUS 827 LINDEN AVENUE BALTIMORE MD 21201 4102258996
210039 CALVERT MEMORIAL HOSPITAL 100 HOSPITAL ROAD PRINCE FREDERICK MD 20678 CALVERT 4105358239 210040 NORTHWEST HOSPITAL CENTER 5401 OLD COURT ROAD RANDALLSTOWN MD 21133 BALTIMORE 4105215995 210043 UNIVERSITY OF MD BALTO WASHINGTON MEDICAL 301 HOSPITAL DRIVE GLEN BURNIE MD 21061 ANNE ARUNDEL 4105951967 CENTER 210044 GREATER BALTIMORE MEDICAL CENTER 6701 NORTH CHARLES STREET BALTIMORE MD 21204 BALTIMORE 4438492000 210045 EDWARD MCCREADY MEMORIAL HOSPITAL 201 HALL HIGHWAY CRISFIELD MD 21817 SOMERSET 4107269496 210048 HOWARD COUNTY GENERAL HOSPITAL 5755 CEDAR LANE COLUMBIA MD 21044 HOWARD 4107407890 210049 UNIVERSITY OF M D UPPER CHESAPEAKE MEDICAL CENTER 500 UPPER CHESAPEAKE DRIVE BEL AIR MD 21014 HARFORD 4436433303
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 96 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 210051 DOCTORS' COMMUNITY HOSPITAL 8118 GOOD LUCK ROAD LANHAM MD 20706 PRINCE GEORGE'S 3015528085 210055 LAUREL REGIONAL MEDICAL CENTER 7300 VAN DUSEN ROAD LAUREL MD 20707 PRINCE GEORGE'S 3017254300 210056 MEDSTAR GOOD SAMARITAN HOSPITAL 5601 LOCH RAVEN BOULEVARD BALTIMORE MD 21239 4434443902 210057 ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER 9901 MEDICAL CENTER DRIVE ROCKVILLE MD 20850 MONTGOMERY 2408266517
210058 UNIV OF MD REHABILITATION & ORTHOPAEDIC INSTITUTE 2200 KERNAN DRIVE BALTIMORE MD 21207 4104486701
21005F BALTIMORE VA REHAB & EXTENDED CARE CENTER (BRECC) 3900 LOCH RAVEN BLVD BALTIMORE MD 21218 4106057000
210060 FORT WASHINGTON HOSPITAL 11711 LIVINGSTON ROAD FORT WASHINGTON MD 20744 PRINCE GEORGE'S 3012927000 210061 ATLANTIC GENERAL HOSPITAL 9733 HEALTHWAY DRIVE BERLIN MD 21811 WORCESTER 4106419600 210062 MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER 7503 SURRATTS ROAD CLINTON MD 20735 PRINCE GEORGE'S 3018688000 210063 UNIVERSITY OF MARYLAND ST JOSEPH MEDICAL CENTER 7601 OSLER DRIVE TOWSON MD 21204 BALTIMORE 4103371000
210064 LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL 2434 WEST BELVEDERE AVENUE BALTIMORE MD 21215 BALTIMORE 4106012400
210065 HOLY CROSS GERMANTOWN HOSPITAL 19801 OBSERVATION DRIVE GERMANTOWN MD 20876 MONTGOMERY 3015576020 21006F CLINICAL CENTER‐NATL INST OF HEALTH 9000 WISCONSIN AVE BETHESDA MD 20014 21007F US NAVAL HOSP NATIONAL NAVAL MEDICAL CENTER BETHESDA MD 20014 21008F KIMBROUGH ARMY HOSP 2480 LEWELLYA FORT GEORGE G MEADE MD 20755 ANNE ARUNDEL 3016778395 21009F FORT HOWARD VA OUTPATIENT CLINIC 9600 NORTH POINT ROAD FORT HOWARD MD 21052 BALTIMORE 4104777177 21010F PERRY POINT VA MEDICAL CENTER CIRCLE DRIVE PERRY POINT MD 21902 CECIL 4106422411 21014E PINE BLUFF STATE HOSP RIVERSIDE DR SALISBURY MD 21801 WICOMICO 21015E MARYLAND PENITENTIARY HOSP 954 FORREST ST BALTIMORE MD 21202 5551111111 21020F BALTIMORE VA MEDICAL CENTER 10 NORTH GREENE STREET BALTIMORE MD 21201 4106057000 212002 WESTERN MARYLAND CENTER 1500 PENNSYLVANIA AVENUE HAGERSTOWN MD 21742 WASHINGTON 3017454140 212003 DEER'S HEAD CENTER 315 DEER'S HEAD HOSPITAL ROAD SALISBURY MD 21802 WICOMICO 4105434000 213028 HEALTHSOUTH CHESAPEAKE REHABILITATION HOSPITAL 220 TILGHMAN ROAD SALISBURY MD 21804 WICOMICO 4105464600
213029 ADVENTIST REHABILITATION HOSPITAL OF MARYLAND 9909 MEDICAL CENTER DRIVE ROCKVILLE MD 20850 MONTGOMERY 2408646005
213300 MOUNT WASHINGTON PEDIATRIC HOSPITAL 1708 WEST ROGERS AVENUE BALTIMORE MD 21209 4105785050 213301 KENNEDY KREIGER INSTITUTE 707 NORTH BROADWAY BALTIMORE MD 21205 4439239305
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 97 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 214000 SHEPPARD AND ENOCH PRATT HOSPITAL, THE 6501 NORTH CHARLES STREET BALTIMORE MD 21204 BALTIMORE 4109383401 214002 EASTERN SHORE HOSPITAL CENTER POST OFFICE BOX 800 CAMBRIDGE MD 21613 DORCHESTER 4102212525 214003 BROOK LANE HEALTH SERVICES 13215 BROOK LANE DRIVE HAGERSTOWN MD 21742 WASHINGTON 3017330330 214004 SPRINGFIELD HOSPITAL CENTER 6655 SYKESVILLE ROAD SYKESVILLE MD 21784 CARROLL 4109707000 214012 THOMAS B FINAN CENTER 10102 COUNTRY CLUB ROAD, POST OFFICE BOX 1722 CUMBERLAND MD 21502 ALLEGANY 3017772240
214013 ADVENTIST HEALTHCARE BEHAVIORAL HEALTH & 14901 BROSCHART ROAD ROCKVILLE MD 20850 MONTGOMERY 3018384959 WELLNESS 214018 SPRING GROVE HOSPITAL CENTER WADE AVENUE CATONSVILLE MD 21228 BALTIMORE 4104027455 219800 JOHNS HOPKINS HOSPITAL, THE 600 NORTH WOLFE STREET BALTIMORE MD 21287 4106145477 219801 UNIVERSITY OF MARYLAND MEDICAL CENTER 22 SOUTH GREENE STREET BALTIMORE MD 21201 4103281715 220001 HEALTHALLIANCE HOSPITALS, INC 60 HOSPITAL ROAD LEOMINSTER MA 01453 9784662000 220002 MOUNT AUBURN HOSPITAL 330 MOUNT AUBURN STREET CAMBRIDGE MA 02138 6174923500 220008 STURDY MEMORIAL HOSPITAL 211 PARK STREET ATTLEBORO MA 02703 BRISTOL 5082225200 220010 LAWRENCE GENERAL HOSPITAL ONE GENERAL STREET LAWRENCE MA 01842 9786834000 220011 CAMBRIDGE HEALTH ALLIANCE 1493 CAMBRIDGE STREET CAMBRIDGE MA 02138 6176652300 220012 CAPE COD HOSPITAL 88 LEWIS BAY ROAD HYANNIS MA 02601 BARNSTABLE 5087711800 220015 COOLEY DICKINSON HOSPITAL INC,THE 30 LOCUST STREET NORTHAMPTON MA 01060 4135822000 220016 BAYSTATE FRANKLIN MEDICAL CENTER 164 HIGH STREET GREENFIELD MA 01301 4137730211 220017 CARNEY HOSPITAL 2100 DORCHESTER AVENUE BOSTON MA 02124 6175062000 220019 HARRINGTON MEMORIAL HOSPITAL‐1 100 SOUTH STREET SOUTHBRIDGE MA 01550 5087659771 22001F VA HOSP 200 SPRINGS ROAD BEDFORD MA 01730 6175551212 220020 SAINT ANNE'S HOSPITAL 795 MIDDLE STREET FALL RIVER MA 02721 BRISTOL 5086745600 220024 HOLYOKE MEDICAL CENTER 575 BEECH STREET HOLYOKE MA 01040 4135342500 220029 ANNA JAQUES HOSPITAL 25 HIGHLAND AVENUE NEWBURYPORT MA 01950 9784631000 22002F U S PUB HLTH SERV HOSP 77 WARREN ST BOSTON MA 02135 6175551212 220030 BAYSTATE WING HOSPITAL AND MEDICAL CENTERS 40 WRIGHT STREET PALMER MA 01069 4132837651 220031 BOSTON MEDICAL CENTER CORPORATION‐ 1 BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 6176388000 220033 BEVERLY HOSPITAL CORPORATION 85 HERRICK STREET BEVERLY MA 01915 9789223000 220035 NORTH SHORE MEDICAL CENTER 81 HIGHLAND AVENUE SALEM MA 01970 9787411215 220036 ST ELIZABETH'S MEDICAL CENTER 736 CAMBRIDGE STREET BRIGHTON MA 02135 6177893000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 98 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 22003F VA HOSP 1400 VFW PARKWAY BOSTON MA 02132 6175551212 220046 BERKSHIRE MEDICAL CENTER INC 725 NORTH STREET PITTSFIELD MA 01201 4134472000 220049 MARLBOROUGH HOSPITAL 157 UNION STREET MARLBOROUGH MA 01752 5084815000 22004F VA HOSP BELMONT STREET BROCKTON MA 02301 PLYMOUTH 6175551212 220050 BAYSTATE MARY LANE HOSPITAL 85 SOUTH STREET WARE MA 01082 4139676211 220052 SIGNATURE HEALTHCARE BROCKTON HOSPITAL 680 CENTER STREET BROCKTON MA 02302 PLYMOUTH 5089417000 220058 CLINTON HOSPITAL ASSOCIATION 201 HIGHLAND STREET CLINTON MA 01510 9783683000 22005F US NAVAL HOSP CHELSEA CHELSEA MA 02150 6175551212 220060 BETH ISRAEL DEACONESS HOSPITAL ‐ PLYMOUTH 275 SANDWICH STREET PLYMOUTH MA 02360 PLYMOUTH 5087462000 220062 ADCARE HOSPITAL OF WORCESTER INC 107 LINCOLN STREET WORCESTER MA 01605 5087999000 220063 LOWELL GENERAL HOSPITAL 295 VARNUM AVENUE LOWELL MA 01854 9789376000 220065 NOBLE HOSPITAL 115 WEST SILVER STREET WESTFIELD MA 01085 4135682811 220066 MERCY MEDICAL CTR 271 CAREW STREET SPRINGFIELD MA 01104 4137489000 22006F US AIR FORCE HOSP WESTOVER AFB CHICOPEE MA 01022 6175551212 220070 HALLMARK HEALTH SYSTEM 585 LEBANON STREET MELROSE MA 02176 7819793000 220071 MASSACHUSETTS GENERAL HOSPITAL 55 FRUIT STREET BOSTON MA 02114 6177262000 220073 MORTON HOSPITAL 88 WASHINGTON STREET TAUNTON MA 02780 BRISTOL 5088287000 220074 SOUTHCOAST HOSPITAL GROUP, INC 363 HIGHLAND AVENUE FALL RIVER MA 02720 BRISTOL 5086793131 220075 MASSACHUSETTS EYE AND EAR INFIRMARY 243 CHARLES STREET BOSTON MA 02114 6175237900 220077 BAYSTATE MEDICAL CENTER 759 CHESTNUT STREET SPRINGFIELD MA 01199 4137940000 22007F US AIR FORCE HOSP OTIS AFB FALMOUTH MA 02540 BARNSTABLE 6175551212 220080 HOLY FAMILY HOSPITAL 70 EAST STREET METHUEN MA 01844 9786870156 220083 BETH ISRAEL DEACONESS HOSPITAL ‐ NEEDHAM 148 CHESTNUT STREET NEEDHAM MA 02494 NORFOLK 7814533002 220084 EMERSON HOSPITAL OLD ROAD TO 9 ACRE CORNER W CONCORD MA 01742 9783691400 220086 BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVENUE BOSTON MA 02215 6176677000 220088 NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVENUE BOSTON MA 02120 6177545800 22008F US ARMY HOSP FORT DEVANS AYER MA 01432 6175551212 220090 MILFORD REGIONAL MEDICAL CENTER 14 PROSPECT STREET MILFORD MA 01757 5084731190 220095 HEYWOOD HOSPITAL 242 GREEN STREET GARDNER MA 01440 9786323420 220098 NASHOBA VALLEY MEDICAL CENTER 200 GROTON ROAD AYER MA 01432 9787849000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 99 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 22009F VA HOSP BERKSHIRE TRAIL ROUTE 9 NORTHAMPTON MA 01060 6175551212 220100 SOUTH SHORE HOSPITAL 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 NORFOLK 7813408000 220101 NEWTON‐WELLESLEY HOSPITAL 2014 WASHINGTON STREET NEWTON MA 02462 6172436000 220105 WINCHESTER HOSPITAL 41 HIGHLAND AVENUE WINCHESTER MA 01890 7817299000 220108 BETH ISRAEL DEACONESS HOSPITAL‐MILTON INC 199 REEDSDALE ROAD MILTON MA 02186 NORFOLK 6176964600 22010F VA HOSP 150 SOUTH HUNTINGTON AVENUE BOSTON MA 02130 6175551212 220110 BRIGHAM AND WOMEN'S HOSPITAL 75 FRANCIS STREET BOSTON MA 02115 6177325500 220111 GOOD SAMARITAN MEDICAL CENTER 235 NORTH PEARL STREET BROCKTON MA 02301 PLYMOUTH 5084273000 220116 TUFTS MEDICAL CENTER 800 WASHINGTON STREET BOSTON MA 02111 6176365000 220119 BRIGHAM AND WOMEN'S FAULKNER HOSPITAL 1153 CENTRE STREET BOSTON MA 02130 6179837000 220126 NORWOOD HOSPITAL 800 WASHINGTON STREET NORWOOD MA 02062 NORFOLK 5087721000 220135 FALMOUTH HOSPITAL 67 & 100 TER HEUN DRIVE FALMOUTH MA 02540 BARNSTABLE 5085485300 220162 DANA‐FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE BOSTON MA 02115 6176323000 220163 UMASS MEMORIAL MEDICAL CENTER INC 55 LAKE AVENUE NORTH WORCESTER MA 01655 5083341000 220171 LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON 41 & 45 MALL ROAD BURLINGTON MA 01803 7817445100 220175 METROWEST MEDICAL CENTER 115 LINCOLN STREET FRAMINGHAM MA 01701 5083831000 220176 ST VINCENT HOSPITAL 123 SUMMER STREET WORCESTER MA 01608 5083635000 220177 NANTUCKET COTTAGE HOSPITAL 57 PROSPECT STREET NANTUCKET MA 02554 5082281200 221300 MARTHA'S VINEYARD HOSPITAL INC ONE HOSPITAL ROAD PO BOX 1477 OAK BLUFFS MA 02557 DUKES 5086930410 221302 FAIRVIEW HOSPITAL 29 LEWIS AVENUE GREAT BARRINGTON MA 01230 4135280790 221303 ATHOL MEMORIAL HOSPITAL 2033 MAIN STREET ATHOL MA 01331 9782493511 221990 CHESTNUT HILL BENEVOLENT ASSOCIATION 910 BOYLSTON STREET CHESTNUT HILL MA 02167 6177345600 222000 SPAULDING HOSPITAL FOR CONTINUING MED CARE‐CAMB 1575 CAMBRIDGE STREET CAMBRIDGE MA 02138 6178764344
222002 KINDRED HOSPITAL NORTHEAST ‐ STOUGHTON 909 SUMNER STREET 1ST FLOOR STOUGHTON MA 02072 NORFOLK 7818482600 222003 TEWKSBURY HOSPITAL 365 EAST STREET TEWKSBURY MA 01876 9788517321 222006 LEMUEL SHATTUCK HOSPITAL 170 MORTON STREET JAMAICA PLAIN MA 02130 6175228110 222007 HEBREW REHABILITATION CENTER 1200 CENTRE STREET BOSTON MA 02131 6173258000 222023 WESTERN MASSACHUSETTS HOSPITAL 91 EAST MOUNTAIN ROAD WESTFIELD MA 01085 4135624131 222025 MASSACHUSETTS HOSPITAL SCHOOL 3 RANDOLPH STREET CANTON MA 02021 NORFOLK 6178282440
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 100 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 222026 SPAULDING HOSPITAL FOR CONTINUING MC ‐ NORTH DOVE AVENUE SALEM MA 01970 9787459000 SHORE 222027 NEW ENGLAND SINAI HOSPITAL 150 YORK STREET STOUGHTON MA 02072 NORFOLK 7813644850 222043 VIBRA HOSPITAL OF SOUTHEASTERN MASSACHUSETTS 4499 ACUSHNET AVENUE NEW BEDFORD MA 02745 BRISTOL 5089956900
222044 KINDRED HOSPITAL ‐ BOSTON NORTH SHORE 15 KING STREET PEABODY MA 01960 5085312900 222045 KINDRED HOSPITAL ‐ BOSTON 1515 COMMONWEALTH AVENUE BOSTON MA 02135 6172541100 222046 VIBRA HOSPITAL OF WESTERN MASSACHUSETTS 1400 STATE STREET SPRINGFIELD MA 01109 4137876700 222047 WHITTIER REHABILITATION HOSPITAL ‐ BRADFORD 145 WARD HILL AVENUE BRADFORD MA 01835 9783728000 222048 WHITTIER REHABILITATION HOSPITAL 150 FLANDERS ROAD WESTBOROUGH MA 01581 5088712063 223026 HEALTHSOUTH NEW ENGLAND REHABILITATION HOSPITAL 2 REHABILITATION WAY WOBURN MA 01801 7819355050
223027 HEALTHSOUTH BRAINTREE REHABILITATION HOSPITAL 250 POND STREET BRAINTREE MA 02184 NORFOLK 7818485353
223029 FAIRLAWN REHABILITATION HOSPITAL 189 MAY STREET WORCESTER MA 01602 5087916351 223030 HEALTHSOUTH REHABILITATION HOSPITAL OF WESTERN 222 STATE STREET LUDLOW MA 01056 4135897581 MA 223032 SPAULDING REHABILITATION HOSPITAL ‐ CAPE COD 311 SERVICE ROAD EAST SANDWICH MA 02537 BARNSTABLE 5088334262 223034 SPAULDING REHABILITATION HOSPITAL 300 FIRST AVENUE CHARLESTOWN MA 02129 6177206400 223300 FRANCISCAN CHILDREN'S HOSPITAL & REHAB CENTER 30 WARREN STREET BRIGHTON MA 02135 6172543800
223302 BOSTON CHILDREN'S HOSPITAL 300 LONGWOOD AVENUE BOSTON MA 02115 6177356000 223303 SHRINERS' HOSPITAL FOR CHILDREN (THE) 516 CAREW STREET SPRINGFIELD MA 01104 4137872000 223304 SHRINERS' HOSPITAL FOR CHILDREN ‐ BOSTON, THE 51 BLOSSOM STREET BOSTON MA 02114 6177223000 224001 TAUNTON STATE HOSPITAL 60 HODGES AVENUE, BOX 151 TAUNTON MA 02780 BRISTOL 5089773000 224007 MCLEAN HOSPITAL CORPORATION 115 MILL STREET BELMONT MA 02478 6178553450 224013 ARBOUR HOSPITAL, THE 49 ROBINWOOD AVENUE BOSTON MA 02130 6175224400 224018 ARBOUR HUMAN RESOURCE INSTITUTE 227 BABCOCK STREET BROOKLINE MA 02146 NORFOLK 6177313200 224021 ARBOUR‐FULLER HOSPITAL 200 MAY STREET SOUTH ATTLEBORO MA 02703 BRISTOL 5087618500 224022 BOURNEWOOD HOSPITAL 300 SOUTH STREET BROOKLINE MA 02146 NORFOLK 6174690300 224023 WESTWOOD PEMBROKE HEALTH SYSTEMS 45 CLAPBOARDTREE STREET WESTWOOD MA 02090 NORFOLK 6177627764 224028 DR JOHN C CORRIGAN MENTAL HEALTH CENTER 49 HILLSIDE STREET FALL RIVER MA 02720 BRISTOL 5082357600
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 101 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 224031 CAPE COD & ISLANDS COMMUNITY MENTAL HEALTH 830 COUNTY ROAD POCASSET MA 02559 BARNSTABLE 5085632276 CENTER 224032 WORCESTER RECOVERY CENTER AND HOSPITAL 309 BELMONT STREET WORCESTER MA 01604 5087524681 224033 BALDPATE HOSPITAL 83 BALDPATE ROAD GEORGETOWN MA 01833 9783522131 224038 WALDEN BEHAVIORAL CARE, LLC 9 HOPE AVENUE WALTHAM MA 02453 7816476727 224039 WHITTIER PAVILION 76 SUMMER STREET HAVERHILL MA 01830 9783738222 224040 DR SOLOMON CARTER FULLER MENTAL HEALTH CENTER 85 EAST NEWTON STREET BOSTON MA 02118 6172668800
224041 SOUTHCOAST BEHAVIORAL HEALTH 581 FAUNCE CORNER ROAD DARTMOUTH MA 02747 BRISTOL 6158616000 224042 HIGH POINT TREATMENT CENTER 52 OAK STREET MIDDLEBORO MA 02346 PLYMOUTH 7746281011 229801 BRIGHAM AND WOMEN'S HOSPITAL ‐ TRANSPLANT 75 FRANCIS STREET BOSTON MA 02115 6177325500 CENTER 229802 LAHEY CLINIC ‐ TRANSPLANT CENTER 41 & 45 MALL ROAD BURLINGTON MA 01803 7817445100 229803 BETH ISRAEL DEACONESS MED CTR ‐ TRANSPLANT CENTER 330 BROOKLINE AVENUE BOSTON MA 02115 6176677000
229804 BOSTON MEDICAL CENTER ‐ TRANSPLANT CENTER 1 BOSTON MEDICAL PLACE BOSTON MA 02118 6176388430 229805 UNIVERSITY OF MASS MEMORIAL MED CTR ‐ TRANSPLANT 55 LAKE AVENUE NORTH WORCESTER MA 01655 5083347177
229806 BOSTON CHILDREN'S HOSPITAL ‐ TRANSPLANT CENTER 300 LONGWOOD AVE BOSTON MA 02115 6173556128
229807 TUFTS MEDICAL CENTER ‐ TRANSPLANT 750 WASHINGTON STREET BOSTON MA 02111 6176364229 229808 MASSACHUSETTS GENERAL HOSPITAL ‐ TRANSPLANT 55 FRUIT STREET BOSTON MA 02114 6177265111 CENTER 229809 BAYSTATE MEDICAL CENTER ‐ TRANSPLANT CENTER 759 CHESTNUT STREET SPRINGFIELD MA 01199 4137942602 230002 ST MARY MERCY HOSPITAL 36475 FIVE MILE ROAD LIVONIA MI 48154 WAYNE 7346554800 230003 SPECTRUM HEALTH ZEELAND COMMUNITY HOSPITAL 8333 FELCH ST ZEELAND MI 49464 OTTAWA 6167724644 230005 PROMEDICA BIXBY HOSPITAL 818 RIVERSIDE AVENUE ADRIAN MI 49221 LENAWEE 5172650900 230013 DOCTORS' HOSPITAL OF MICHIGAN 461 W HURON ST PONTIAC MI 48341 OAKLAND 2488577200 230015 THREE RIVERS HEALTH 701 S HEALTH PARKWAY THREE RIVERS MI 49093 ST. JOSEPH 2692739602 230017 BRONSON METHODIST HOSPITAL 601 JOHN STREET KALAMAZOO MI 49007 KALAMAZOO 2693416000 230019 PROVIDENCE ‐ PROVIDENCE PARK HOSPITAL 16001 W NINE MILE RD SOUTHFIELD MI 48075 OAKLAND 2488493011 230020 BEAUMONT HOSPITAL ‐ DEARBORN 18101 OAKWOOD BLVD DEARBORN MI 48124 WAYNE 3135937125 230021 LAKELAND HOSPITAL, ST JOSEPH 1234 NAPIER AVENUE ST JOSEPH MI 49085 BERRIEN 2699838300
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 102 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 230022 COMMUNITY HEALTH CENTER OF BRANCH COUNTY 274 E CHICAGO ST COLDWATER MI 49036 BRANCH 5172795400 230024 SINAI‐GRACE HOSPITAL 6071 W OUTER DRIVE DETROIT MI 48235 WAYNE 3139663300 230029 ST JOSEPH MERCY OAKLAND 44405 WOODWARD AVE PONTIAC MI 48341 OAKLAND 2488583000 230030 MIDMICHIGAN MEDICAL CENTER‐GRATIOT 300 E WARWICK DR ALMA MI 48801 GRATIOT 9894631101 230031 LAKE HURON MEDICAL CENTER 2601 ELECTRIC AVENUE PORT HURON MI 48060 ST. CLAIR 8109851500 230035 SPECTRUM HEALTH UNITED HOSPITAL 615 S BOWER STREET GREENVILLE MI 48838 MONTCALM 6167544691 230036 MIDMICHGAN MEDICAL CENTER ‐ ALPENA 1501 W CHISHOLM ST ALPENA MI 49707 ALPENA 9893567390 230037 HILLSDALE HOSPITAL 168 S HOWELL STREET HILLSDALE MI 49242 HILLSDALE 5174374451 230038 SPECTRUM HEALTH ‐ BUTTERWORTH CAMPUS 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 KENT 6163911774 230040 SPECTRUM HEALTH PENNOCK 1009 W GREEN ST HASTINGS MI 49058 BARRY 2699453451 230041 MCLAREN BAY REGION 1900 COLUMBUS AVE BAY CITY MI 48708 BAY 9898943000 230046 UNIVERSITY OF MICHIGAN HEALTH SYSTEM 1500 E MEDICAL CENTER DRIVE, SPC 5474 ANN ARBOR MI 48109 WASHTENAW 7347641505 230047 HENRY FORD MACOMB HOSPITAL 15855 NINETEEN MILE RD CLINTON TOWNSHIP MI 48038 MACOMB 5862632300 230053 HENRY FORD HOSPITAL 2799 W GRAND BLVD DETROIT MI 48202 WAYNE 3139162600 230054 UP HEALTH SYSTEM ‐ MARQUETTE 420 W MAGNETIC MARQUETTE MI 49855 MARQUETTE 9062289440 230055 DICKINSON COUNTY MEMORIAL HOSPITAL 1721 S STEPHENSON AVE IRON MOUNTAIN MI 49801 DICKINSON 9067741313 230058 MUNSON HEALTHCARE GRAYLING HOSPITAL 1100 E MICHIGAN AVE GRAYLING MI 49738 CRAWFORD 9893485461 230059 SAINT MARY'S HEALTH CARE 200 JEFFERSON AVENUE SE GRAND RAPIDS MI 49503 KENT 6166855000 23005F IRON MOUNTAIN VA MEDICAL CENTER 325 EAST H STREET IRON MOUNTAIN MI 49801 DICKINSON 9067743300 230066 MERCY HEALTH MUSKEGON 1700 CLINTON STREET MUSKEGON MI 49442 MUSKEGON 2317263511 230069 SAINT JOSEPH MERCY LIVINGSTON HOSPITAL 620 BYRON RD HOWELL MI 48843 LIVINGSTON 5175456000 23006F FEDERAL CORRECTIONAL INSTITUTE HOSP 4004 E ARKONA RD MILAN MI 48160 MONROE 2690000000 230070 COVENANT MEDICAL CENTER 1447 N HARRISON SAGINAW MI 48602 SAGINAW 9895834000 230071 STRAITH HOSPITAL FOR SPECIAL SURGERY 23901 LAHSER SOUTHFIELD MI 48033 OAKLAND 2483573360 230072 HOLLAND COMMUNITY HOSPITAL 602 MICHIGAN AVE HOLLAND MI 49423 OTTAWA 6163925141 230075 BRONSON BATTLE CREEK HOSPITAL 300 NORTH AVENUE BATTLE CREEK MI 49017 CALHOUN 2699668000 230077 ST MARY'S OF MICHIGAN MEDICAL CENTER 800 S WASHINGTON AVENUE SAGINAW MI 48601 SAGINAW 9897768000 230078 LAKELAND HOSPITAL WATERVLIET 400 MEDICAL PARK DR WATERVLIET MI 49098 BERRIEN 2694633111 23007F US AIR FORCE HOSP SELFRIDGE AFB MOUNT CLEMENS MI 48045 MACOMB 2690000000 230080 MCLAREN CENTRAL MICHIGAN 1221 SOUTH DRIVE MOUNT PLEASANT MI 48858 ISABELLA 9897726700
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 103 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 230081 MUNSON HEALTHCARE CADILLAC HOSPITAL 400 HOBART ST CADILLAC MI 49601 WEXFORD 2318767200 230085 SOUTH HAVEN COMMUNITY HOSPITAL 955 S BAILEY AVE SOUTH HAVEN MI 49090 VAN BUREN 2696375271 230089 BEAUMONT HOSPITAL, GROSSE POINTE 468 CADIEUX RD GROSSE POINTE MI 48230 WAYNE 3133431000 23008F US AIR FORCE HOSP WURTSMITH AFB OSCODA MI 48750 IOSCO 2690000000 230092 HENRY FORD ALLEGIANCE HEALTH 205 N EAST AVE JACKSON MI 49201 JACKSON 5177884800 230093 SPECTRUM HEALTH BIG RAPIDS HOSPITAL 605 OAK STREET BIG RAPIDS MI 49307 MECOSTA 2317968691 230095 WEST BRANCH REGIONAL MEDICAL CENTER 2463 SOUTH M‐30 WEST BRANCH MI 48661 OGEMAW 9893456366 230096 STURGIS HOSPITAL 916 MYRTLE AVE STURGIS MI 49091 ST. JOSEPH 2696517824 230097 MUNSON MEDICAL CENTER 1105 SIXTH STREET TRAVERSE CITY MI 49684 GRAND TRAVERSE 2319355000 230099 PROMEDICA MONROE REGIONAL HOSPITAL 718 N MACOMB ST MONROE MI 48162 MONROE 7342408400 23009F ALEDA E LUTZ VA MEDICAL CENTER 1500 WEISS STREET SAGINAW MI 48602 SAGINAW 9894972500 230100 TAWAS ST JOSEPH HOSPITAL 200 HEMLOCK TAWAS CITY MI 48764 IOSCO 9893629301 230104 HARPER UNIVERSITY HOSPITAL 3990 JOHN R STREET DETROIT MI 48201 WAYNE 3137456211 230105 MCLAREN ‐ NORTHERN MICHIGAN 416 CONNABLE AVE PETOSKEY MI 49770 EMMET 2314874000 230108 UP HEALTH SYSTEM PORTAGE 500 CAMPUS DRIVE HANCOCK MI 49930 HOUGHTON 9064831000 23010F US AIR FORCE HOSP KINCHELOE AFB KINCHELOE MI 49788 CHIPPEWA 9060000000 230110 SPECTRUM HEALTH LUDINGTON HOSPITAL ONE N ATKINSON DRIVE LUDINGTON MI 49431 MASON 2318432591 230117 BORGESS MEDICAL CENTER 1521 GULL ROAD KALAMAZOO MI 49048 KALAMAZOO 2692267000 230118 HURON MEDICAL CENTER 1100 SOUTH VAN DYKE ROAD BAD AXE MI 48413 HURON 9892699521 23011F VA ANN ARBOR HEALTHCARE SYSTEM 2215 FULLER ROAD ANN ARBOR MI 48105 WASHTENAW 7347697100 230121 MEMORIAL HEALTHCARE 826 WEST KING STREET OWOSSO MI 48867 SHIAWASSEE 9897235211 230125 BERRIEN GENERAL HOSPITAL 6418 DEANS HILL RD BERRIEN CENTER MI 49102 BERRIEN 6164717761 23012F BATTLE CREEK VA MEDICAL CENTER 5500 ARMSTRONG ROAD BATTLE CREEK MI 49015 CALHOUN 2699665600 230130 BEAUMONT HOSPITAL, ROYAL OAK 3601 W THIRTEEN MILE RD ROYAL OAK MI 48073 OAKLAND 2488985000 230132 HURLEY MEDICAL CENTER ONE HURLEY PLAZA FLINT MI 48503 GENESEE 8102579000 230133 OTSEGO MEMORIAL HOSPITAL 825 N CENTER AVE GAYLORD MI 49735 OTSEGO 9897312100 23013F VA HOSP SOUTHFIELD + OUTER DR DEARBORN MI 48121 WAYNE 2480000000 230141 MCLAREN FLINT 401 S BALLENGER HIGHWAY FLINT MI 48532 GENESEE 8103422000 230142 BEAUMONT HOSPITAL ‐ WAYNE 33155 ANNAPOLIS AVE WAYNE MI 48184 WAYNE 7344674175 230144 FOREST HEALTH MEDICAL CENTER 135 S PROSPECT ST YPSILANTI MI 48198 WASHTENAW 7345474700
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 104 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 230146 HENRY FORD WYANDOTTE HOSPITAL 2333 BIDDLE AVE WYANDOTTE MI 48192 WAYNE 7342466000 23014F US AIR FORCE HOSP SAWYER AFB GWINN MI 49841 MARQUETTE 9060000000 230151 BEAUMONT HOSPITAL ‐ FARMINGTON HILLS 28050 GRAND RIVER AVENUE FARMINGTON HILLS MI 48336 OAKLAND 2484718000 230156 ST JOSEPH MERCY HOSPITAL 5301 E HURON RIVER DR ANN ARBOR MI 48106 WASHTENAW 7347123456 230165 ST JOHN HOSPITAL AND MEDICAL CENTER 22101 MOROSS RD DETROIT MI 48236 WAYNE 3133434000 230167 MCLAREN GREATER LANSING 401 W GREENLAWN AVE LANSING MI 48910 INGHAM 5179756000 230174 NORTH OTTAWA COMMUNITY HEALTH SYSTEM 1309 SHELDON RD GRAND HAVEN MI 49417 OTTAWA 6168423600 230176 BEAUMONT HOSPITAL ‐ TRENTON 5450 FORT STREET TRENTON MI 48183 WAYNE 7346713800 230180 MIDMICHIGAN MEDICAL CENTER‐CLARE 703 N MCEWAN ST CLARE MI 48617 CLARE 9898025000 230193 MCLAREN LAPEER REGION 1375 N MAIN ST LAPEER MI 48446 LAPEER 8106675500 230195 ST JOHN MACOMB‐OAKLAND HOSPITAL‐MACOMB CENTER 11800 EAST TWELVE MILE ROAD WARREN MI 48093 MACOMB 5865735000
230197 GENESYS REGIONAL MEDICAL CENTER ‐ HEALTH PARK ONE GENESYS PARKWAY GRAND BLANC MI 48439 GENESEE 8106065000 230207 MCLAREN OAKLAND 50 NORTH PERRY PONTIAC MI 48342 OAKLAND 2483385000 230208 SPARROW CARSON HOSPITAL 406 EAST ELM ST CARSON CITY MI 48811 MONTCALM 9895843131 230216 MCLAREN PORT HURON 1221 PINE GROVE AVE PORT HURON MI 48060 ST. CLAIR 8109875000 230217 OAKLAWN HOSPITAL 200 N MADISON MARSHALL MI 49068 CALHOUN 2697814271 230222 MIDMICHIGAN MEDICAL CENTER‐MIDLAND 4000 WELLNESS DRIVE MIDLAND MI 48670 MIDLAND 9898393000 230227 MCLAREN MACOMB 1000 HARRINGTON BLVD MOUNT CLEMENS MI 48043 MACOMB 5864938000 230230 EDWARD W SPARROW HOSPITAL 1215 E MICHIGAN AVENUE LANSING MI 48912 INGHAM 5173641000 230236 METRO HEALTH HOSPITAL 5900 BYRON CENTER AVENUE, SW WYOMING MI 49519 KENT 6162527200 230239 CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL 500 OSBORN BLVD SAULT SAINTE MARIE MI 49783 CHIPPEWA 9066354460 230241 ST JOHN RIVER DISTRICT HOSPITAL 4100 RIVER RD EAST CHINA MI 48054 ST. CLAIR 8103297111 230244 GARDEN CITY HOSPITAL 6245 INKSTER RD GARDEN CITY MI 48135 WAYNE 7344213300 230254 CRITTENTON HOSPITAL MEDICAL CENTER 1101 W UNIVERSITY DRIVE ROCHESTER MI 48307 OAKLAND 2486525000 230259 ST JOSEPH MERCY CHELSEA 775 S MAIN ST CHELSEA MI 48118 WASHTENAW 7344753911 230264 SOUTHEAST MICHIGAN SURGICAL HOSPITAL 21230 DEQUINDRE ROAD WARREN MI 48091 MACOMB 5864271000 230269 BEAUMONT HOSPITAL, TROY 44201 DEQUINDRE ROAD TROY MI 48085 OAKLAND 2489648800 230270 BEAUMONT HOSPITAL ‐ TAYLOR 10000 TELEGRAPH ROAD TAYLOR MI 48180 WAYNE 3132955253 230273 DETROIT RECEIVING HOSPITAL & UNIV HEALTH CENTER 4201 ST ANTOINE ST ‐ 3M DETROIT MI 48201 WAYNE 3137453104
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 105 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 230275 HEALTHSOURCE SAGINAW 3340 HOSPITAL ROAD SAGINAW MI 48603 SAGINAW 9897907888 230277 HURON VALLEY‐SINAI HOSPITAL ONE WILLIAM CARLS DRIVE COMMERCE TOWNSHIP MI 48382 OAKLAND 2489373370 230279 BRIGHTON HOSPITAL 12851 GRAND RIVER RD BRIGHTON MI 48116 LIVINGSTON 8102271211 230297 KARMANOS CANCER CENTER 4100 JOHN R DETROIT MI 48201 WAYNE 8005766266 230301 OAKLAND REGIONAL HOSPITAL 22401 FOSTER WINTER DRIVE SOUTHFIELD MI 48075 OAKLAND 2484235100 230302 HENRY FORD WEST BLOOMFIELD HOSPITAL 6777 WEST MAPLE ROAD WEST BLOOMFIELD MI 48322 OAKLAND 2483251000 230303 WEST SHORE MEDICAL CENTER 1465 E PARKDALE AVE MANISTEE MI 49660 MANISTEE 2313981000 23036F US PUBLIC HEALTH SERVICE HOSP 14700 RIVERSIDE DR DETROIT MI 48215 WAYNE 3130000000 23037F JOHN D DINGELL VETERAN AFFAIRS MED CTR 4646 JOHN R STREET DETROIT MI 48201 WAYNE 3135761000 231300 PAUL OLIVER MEMORIAL HOSPITAL 224 PARK AVENUE FRANKFORT MI 49635 BENZIE 2313522200 231301 KALKASKA MEMORIAL HEALTH CENTER 419 S CORAL KALKASKA MI 49646 KALKASKA 2312587500 231303 SCHOOLCRAFT MEMORIAL HOSPITAL 7870W US HIGHWAY 2 MANISTIQUE MI 49854 SCHOOLCRAFT 9063413200 231304 HELEN NEWBERRY JOY HOSPITAL 502 W HARRIE ST NEWBERRY MI 49868 LUCE 9062939200 231305 SAINT MARY'S STANDISH COMMUNITY HOSPITAL 805 W CEDAR ST STANDISH MI 48658 ARENAC 5178464521 231306 MACKINAC STRAITS HOSPITAL AND HEALTH CENTER 1140 N STATE STREET SAINT IGNACE MI 49781 MACKINAC 9066438585 231307 BARAGA COUNTY MEMORIAL HOSPITAL 18341 US HIGHWAY 41 L' ANSE MI 49946 BARAGA 9065243300 231308 MUNISING MEMORIAL HOSPITAL 1500 SAND POINT RD MUNISING MI 49862 ALGER 9063874110 231309 ASPIRUS ONTONAGON HOSPITAL, INC 601 S SEVENTH ST ONTONAGON MI 49953 ONTONAGON 9068848000 231310 SCHEURER HOSPITAL 170 N CASEVILLE RD PIGEON MI 48755 HURON 9894533223 231311 DECKERVILLE COMMUNITY HOSPITAL 3559 PINE ST DECKERVILLE MI 48427 SANILAC 8103762835 231312 SHERIDAN COMMUNITY HOSPITAL 301 N MAIN ST SHERIDAN MI 48884 MONTCALM 9892913261 231313 HARBOR BEACH COMMUNITY HOSPITAL 210 S FIRST ST HARBOR BEACH MI 48441 HURON 9894793201 231314 MCKENZIE HEALTH SYSTEM 120 N DELAWARE STREET SANDUSKY MI 48471 SANILAC 8106483770 231315 BORGESS‐LEE MEMORIAL HOSPITAL 420 W HIGH STREET DOWAGIAC MI 49047 CASS 2697828681 231316 HILLS & DALES GENERAL HOSPITAL 4675 HILL STREET CASS CITY MI 48726 TUSCOLA 9898722121 231317 SPECTRUM HEALTH KELSEY HOSPITAL 418 WASHINGTON LAKEVIEW MI 48850 MONTCALM 9893527211 231318 ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC 1400 W ICE LAKE ROAD IRON RIVER MI 49935 IRON 9062656121 231319 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA LAURIUM MI 49913 HOUGHTON 9063376500 231320 MERCY HEALTH LAKESHORE CAMPUS 72 SOUTH STATE STREET SHELBY MI 49455 OCEANA 2318612156 231321 BELL HOSPITAL 901 LAKESHORE DRIVE ISHPEMING MI 49849 MARQUETTE 9064864431
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 106 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 231322 MUNSON HEALTHCARE CHARLEVOIX HOSPITAL 14700 LAKESHORE DRIVE CHARLEVOIX MI 49720 CHARLEVOIX 2315474024 231323 SPECTRUM HEALTH REED CITY HOSPITAL 300 N PATTERSON, PO BOX 75 REED CITY MI 49677 OSCEOLA 2318323271 231324 EATON RAPIDS MEDICAL CENTER 1500 S MAIN STREET EATON RAPIDS MI 48827 EATON 5176632671 231325 MIDMICHIGAN MEDICAL CENTER‐GLADWIN 515 QUARTER STREET GLADWIN MI 48624 GLADWIN 9894269286 231326 SPARROW CLINTON HOSPITAL 805 S OAKLAND SAINT JOHNS MI 48879 CLINTON 9892246881 231327 HAYES GREEN BEACH MEMORIAL HOSPITAL 321 E HARRIS STREET CHARLOTTE MI 48813 EATON 5175431050 231328 ALLEGAN GENERAL HOSPITAL 555 LINN STREET ALLEGAN MI 49010 ALLEGAN 2696864101 231329 CARO COMMUNITY HOSPITAL 401 N HOOPER STREET CARO MI 48723 TUSCOLA 9896733141 231330 MARLETTE REGIONAL HOSPITAL 2770 MAIN STREET MARLETTE MI 48453 SANILAC 9896354000 231331 SPARROW IONIA HOSPITAL 3565 S STATE ROAD IONIA MI 48846 IONIA 6165274200 231332 BRONSON LAKEVIEW HOSPITAL 408 HAZEN STREET PAW PAW MI 49079 VAN BUREN 2696571400 231333 ASPIRUS GRAND VIEW HOSPITAL N10561 GRAND VIEW LANE IRONWOOD MI 49938 GOGEBIC 9069322525 231334 PROMEDICA HERRICK HOSPITAL 500 E POTTAWATAMIE STREET TECUMSEH MI 49286 LENAWEE 5174243000 231337 ST FRANCIS HOSPITAL 3401 LUDINGTON ST ESCANABA MI 49829 DELTA 9067863311 231338 SPECTRUM HEALTH GERBER MEMORIAL 212 S SULLIVAN ST FREMONT MI 49412 NEWAYGO 2319243300 232012 SELECT SPECIALTY HOSPITAL‐FLINT 401 S BALLENGER, 5TH FLOOR FLINT MI 48532 GENESEE 8103424550 232019 VIBRA OF SOUTHEASTERN MICHIGAN 26400 W OUTER DRIVE LINCOLN PARK MI 48146 WAYNE 3135946000 232020 MCLAREN BAY SPECIAL CARE 3250 E MIDLAND RD, SUITE 1BAY CITY MI 48706 BAY 9896676802 232021 SELECT SPECIALTY HOSPITAL ‐ MUSKEGON 1700 CLINTON STREET, 2 SOUTH AND 3 SOUTH FLOORS MUSKEGON MI 49442 MUSKEGON 2317285800
232023 SELECT SPECIALTY HOSPITAL‐MACOMB COUNTY 215 NORTH AVE, SUITE 200 MOUNT CLEMENS MI 48043 MACOMB 5863079000 232024 SELECT SPECIALTY HOSPITAL‐ANN ARBOR 5301 E HURON RIVER DR, 7TH FL YPSILANTI MI 48197 WASHTENAW 7347120500 232026 SELECT SPECIALTY HOSPITAL ‐ GRAND RAPIDS 200 SE JEFFERSON, 5TH FLOOR GRAND RAPIDS MI 49503 KENT 2316726202 232027 KINDRED HOSPITAL DETROIT 4777 E OUTER DRIVE DETROIT MI 48234 WAYNE 3133695800 232029 SPECTRUM HEALTH KENT COMMUNITY CAMPUS 750 FULLER AVE NE GRAND RAPIDS MI 49503 KENT 6164862453 232030 SELECT SPECIALTY HOSPITAL‐PONTIAC 44405 WOODWARD AVENUE, 8TH FLOOR PONTIAC MI 48341 OAKLAND 2484525200 232031 SELECT SPECIALTY HOSPITAL‐WYANDOTTE, LLC 2333 BIDDLE AVENUE, 8TH FLOOR WYANDOTTE MI 48192 WAYNE 3133757075 232032 SELECT SPECIALTY HOSPITAL‐NORTHWEST DETROIT 6071 WEST OUTER DRIVE, 7TH FLOOR DETROIT MI 48235 WAYNE 3139663939 232033 SELECT SPECIALTY HOSPITAL‐SAGINAW 1447 NORTH HARRISON, 7TH & 8TH FLOOR SAGINAW MI 48602 SAGINAW 9895834667 232034 BORGESS PIPP HOSPITAL 411 NAOMI STREET PLAINWELL MI 49080 ALLEGAN 2696850700
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 107 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 232035 SELECT SPECIALTY HOSPITAL‐ BATTLE CREEK 300 NORTH AVENUE 6TH FLOOR BATTLE CREEK MI 49016 CALHOUN 2692454675 232036 HENRY FORD ALLEGIANCE CARELINK 110 N ELM AVENUE JACKSON MI 49202 JACKSON 5177964426 232037 SPARROW SPECIALTY HOSPITAL 1215 E MICHIGAN AVE, 8W SPARROW HOSPITAL TOWER LANSING MI 48912 INGHAM 5173646800
232038 SELECT SPECIALTY HOSPITAL‐GROSSE POINTE 22101 MOROSS ROAD DETROIT MI 48236 WAYNE 3136402220 232039 PIONEER SPECIALTY HOSPITAL 50 NORTH PERRY PONTIAC MI 48342 OAKLAND 2485931990 233026 MARY FREE BED HOSPITAL & REHABILITATION CENTER 235 WEALTHY SE GRAND RAPIDS MI 49503 KENT 6162420300
233027 REHABILITATION INSTITUTE OF MICHIGAN 261 MACK BLVD DETROIT MI 48201 WAYNE 3137459710 233300 CHILDREN'S HOSPITAL OF MICHIGAN 3901 BEAUBIEN STREET DETROIT MI 48201 WAYNE 3137455437 234006 PINE REST CHRISTIAN MENTAL HEALTH SERVICES 300 ‐ 68TH STREET, SE GRAND RAPIDS MI 49548 KENT 6164555000 234011 HENRY FORD KINGSWOOD HOSPITAL 10300 W EIGHT MILE ROAD FERNDALE MI 48220 OAKLAND 2486914868 234021 HARBOR OAKS HOSPITAL 35031 23 MILE RD NEW BALTIMORE MI 48047 MACOMB 5867255777 234023 HAVENWYCK HOSPITAL 1525 UNIVERSITY DRIVE AUBURN HILLS MI 48326 OAKLAND 2483739200 234025 CARO CENTER 2000 CHAMBERS, BOX A CARO MI 48723 TUSCOLA 9896733191 234026 KALAMAZOO REGIONAL PSYCHIATRIC HOSPITAL 1312 OAKLAND DR KALAMAZOO MI 49008 KALAMAZOO 2693373309 234030 FOREST VIEW PSYCHIATRIC HOSPITAL 1055 MEDICAL PARK SE GRAND RAPIDS MI 49546 KENT 6169429610 234035 WALTER P REUTHER PSYCHIATRIC HOSPITAL 30901 PALMER RD WESTLAND MI 48185 WAYNE 7343678400 234038 BCA STONECREST CENTER 15000 GRATIOT AVENUE DETROIT MI 48205 WAYNE 3132450600 234040 SAMARITAN BEHAVIORAL CENTER 5555 CONNER AVENUE, SUITE 3N DETROIT MI 48213 WAYNE 3133447730 234041 THE CENTER FOR FORENSIC PSYCHIATRY 8303 PLATT ROAD SALINE MI 48176 WASHTENAW 7344292531 234042 THE BEHAVIORAL CENTER OF MICHIGAN 4050 E 12 MILE ROAD WARREN MI 48092 MACOMB 5862612266 239801 HENRY FORD HOSPITAL 2799 W GRAND BLVD DETROIT MI 48202 WAYNE 3139168058 239802 CHILDRENS OF MI TRANSPLANT 3901 BEAUBIEN BLVD DETROIT MI 48201 WAYNE 3137451401 239803 UNIVERSITY OF MICHIGAN MEDICAL CENTER 1500 E MEDICAL CTR DR, 3868 TAUBMAN CENTER, SPC ANN ARBOR MI 48109 WASHTENAW 7347644141
239804 ST JOHN HOSPITAL ‐ TRANSPLANT 22101 MOROSS DETROIT MI 48236 WAYNE 3133433134 239805 HARPER UNIVERSITY HOSPITAL 3990 JOHN R DETROIT MI 48201 WAYNE 3137456211 239806 BEAUMONT HEALTH SYSTEM 3601 W 13 MILE RD ROYAL OAK MI 48073 OAKLAND 2485511033 239807 DEVOS CHILDRENS HOSPITAL ‐ TRANSPLANT UNIT 100 MICHIGAN STREET NE GRAND RAPIDS MI 49503 KENT 6163919000 239808 SAINT MARY'S HEALTH CARE 200 JEFFERSON ST SE GRAND RAPIDS MI 49503 KENT 6167526889
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 108 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 239809 SPECTRUM HEALTH ADULT SOLID ORGAN TRANSPLANT 100 MICHIGAN ST, NE MC231 GRAND RAPIDS MI 49503 KENT 6163910800 PROGR 240001 NORTH MEMORIAL MEDICAL CENTER 3300 OAKDALE NORTH ROBBINSDALE MN 55422 HENNEPIN 7635205200 240002 ESSENTIA HEALTH ST MARY'S MEDICAL CENTER 407 EAST THIRD STREET DULUTH MN 55805 ST. LOUIS 2187864000 240004 HENNEPIN COUNTY MEDICAL CENTER 1 701 PARK AVENUE MINNEAPOLIS MN 55415 HENNEPIN 6128732338 240006 OLMSTED MEDICAL CENTER 1650 FOURTH STREET SOUTHEAST ROCHESTER MN 55904 OLMSTED 5072872761 240010 MAYO CLINIC HOSPITAL ROCHESTER 1216 SECOND STREET SOUTHWEST ROCHESTER MN 55902 OLMSTED 5072555123 240014 NORTHFIELD HOSPITAL 2000 NORTH AVENUE NORTHFIELD MN 55057 DAKOTA 5076461001 240018 MAYO CLINIC HEALTH SYSTEM IN RED WING 701 HEWITT BOULEVARD, PO BOX 95 RED WING MN 55066 GOODHUE 6512675000 240019 ESSENTIA HEALTH DULUTH 502 EAST SECOND STREET DULUTH MN 55805 ST. LOUIS 2187862646 240020 CAMBRIDGE MEDICAL CENTER 701 SOUTH DELLWOOD AVENUE CAMBRIDGE MN 55008 ISANTI 7636897700 240022 SANFORD WORTHINGTON MEDICAL CENTER 1018 SIXTH AVENUE PO BOX 997 WORTHINGTON MN 56187 NOBLES 5073723380 24002F VA HOSP SAINT CLOUD MN 56303 STEARNS 3202521670 240030 DOUGLAS COUNTY HOSPITAL 111 17TH AVENUE EAST ALEXANDRIA MN 56308 DOUGLAS 3207621511 240036 ST CLOUD HOSPITAL 1406 6TH AVE NORTH SAINT CLOUD MN 56303 STEARNS 3202512700 240038 UNITED HOSPITAL 333 NORTH SMITH AVENUE SAINT PAUL MN 55102 RAMSEY 6512418802 24003F VETERANS AFFAIRS MEDICAL CENTER ONE VETERANS DRIVE MINNEAPOLIS MN 55417 HENNEPIN 6127252000 240040 UNIVERSITY MEDICAL CENTER‐MESABI/ MESABA CLINICS 750 EAST 34TH ST HIBBING MN 55746 ST. LOUIS 2183626659
240043 MAYO CLINIC HEALTH SYSTEM ‐ ALBERT LEA 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 FREEBORN 5073732384 240044 WINONA HEALTH SERVICES 855 MANKATO AVENUE WINONA MN 55987 WINONA 5074543650 240047 ST LUKES HOSPITAL 915 EAST 1ST STREET DULUTH MN 55805 ST. LOUIS 2182495555 240050 FAIRVIEW LAKES MEDICAL CENTER 5200 FAIRVIEW BOULEVARD WYOMING MN 55092 CHISAGO 6519827104 240052 LAKE REGION HEALTHCARE CORPORATION 712 SOUTH CASCADE FERGUS FALLS MN 56537 OTTER TAIL 2187368190 240053 PARK NICOLLET METHODIST HOSPITAL 6500 EXCELSIOR BLVD SAINT LOUIS PARK MN 55426 HENNEPIN 9529935000 240056 RIDGEVIEW MEDICAL CENTER 500 SOUTH MAPLE STREET WACONIA MN 55387 CARVER 9524422191 240057 ABBOTT NORTHWESTERN HOSPITAL 800 EAST 28TH STREET MINNEAPOLIS MN 55407 HENNEPIN 6128634509 240059 REGINA HOSPITAL 1175 NININGER ROAD HASTINGS MN 55033 DAKOTA 6514804100 240063 ST JOSEPH'S HOSPITAL 45 WEST 10TH STREET SAINT PAUL MN 55102 RAMSEY 6512327707 240064 GRAND ITASCA CLINIC AND HOSPITAL 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 ITASCA 2183263401 240066 LAKEVIEW MEMORIAL HOSPITAL 927 WEST CHURCHILL STREET STILLWATER MN 55082 WASHINGTON 6514305330
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 109 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 240069 OWATONNA HOSPITAL 2250 26TH STREET NORTHWEST OWATONNA MN 55060 STEELE 5079772337 240071 DISTRICT ONE HOSPITAL 200 STATE AVENUE FARIBAULT MN 55021 RICE 5073346451 240075 ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER 523 NORTH 3RD STREET BRAINERD MN 56401 CROW WING 2188292861 240076 BUFFALO HOSPITAL 303 CATLIN ST BUFFALO MN 55313 WRIGHT 7636841212 240078 FAIRVIEW SOUTHDALE HOSPITAL 6401 FRANCE AVENUE SOUTH EDINA MN 55435 HENNEPIN 9529245000 240080 UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 HENNEPIN 6122733000
240084 ESSENTIA HEALTH VIRGINIA 901 9TH STREET NORTH VIRGINIA MN 55792 ST. LOUIS 2187413340 240088 RICE MEMORIAL HOSPITAL 301 BECKER AVE SW WILLMAR MN 56201 KANDIYOHI 3202314227 240093 MAYO CLINIC HEALTH SYSTEM ‐ MANKATO 1025 MARSH STREET MANKATO MN 56001 BLUE EARTH 5076254031 240100 SANFORD BEMIDJI MEDICAL CENTER 1300 ANNE ST NW BEMIDJI MN 56601 BELTRAMI 2187515430 240101 ESSENTIA HEALTH ST MARYS ‐ DETROIT LAKES 1027 WASHINGTON AVE DETROIT LAKES MN 56501 BECKER 2188470888 240104 ST FRANCIS REGIONAL MEDICAL CENTER 1455 ST FRANCIS AVENUE SHAKOPEE MN 55379 SCOTT 9524033000 240106 REGIONS HOSPITAL 640 JACKSON STREET SAINT PAUL MN 55101 RAMSEY 6512543456 240115 MERCY HOSPITAL 4050 COON RAPIDS BLVD COON RAPIDS MN 55433 ANOKA 7632368205 240132 UNITY HOSPITAL 550 OSBORNE ROAD FRIDLEY MN 55432 ANOKA 7632365000 240141 FAIRVIEW NORTHLAND REGIONAL HOSPITAL 911 NORTHLAND DR PRINCETON MN 55371 SHERBURNE 7633891313 240166 MAYO CLINIC HEALTH SYSTEM ‐ FAIRMONT 800 MEDICAL CENTER DRIVE, PO BOX 800 FAIRMONT MN 56031 MARTIN 5072388101 240187 HUTCHINSON HEALTH 1095 HIGHWAY 15 SOUTH HUTCHINSON MN 55350 MCLEOD 3202345000 240196 PHILLIPS EYE INSTITUTE 2215 PARK AVENUE SOUTH MINNEAPOLIS MN 55404 HENNEPIN 6127758815 240206 RED LAKE HOSPITAL APO BOX 497 REDLAKE MN 56671 BELTRAMI 2186793912 240207 FAIRVIEW RIDGES HOSPITAL 201 EAST NICOLLET BOULEVARD BURNSVILLE MN 55337 DAKOTA 9528922000 240210 HEALTHEAST ST JOHN'S HOSPITAL 1575 BEAM AVENUE MAPLEWOOD MN 55109 RAMSEY 6512327000 240213 HEALTHEAST WOODWINDS HOSPITAL 1925 WOODWINDS DRIVE WOODBURY MN 55125 WASHINGTON 6512322185 240214 MAPLE GROVE HOSPITAL 9875 HOSPITAL DRIVE MAPLE GROVE MN 55369 HENNEPIN 7635811000 241300 MAHNOMEN HEALTH CENTER 414 W JEFFERSON PO BOX 396 MAHNOMEN MN 56557 MAHNOMEN 2189352511 241301 LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE MN 56623 LAKE OF THE WOODS 2186342120 241302 SANFORD WESTBROOK MEDICAL CENTER 920 BELL AVENUE PO BOX 188 WESTBROOK MN 56183 COTTONWOOD 5072746121 241303 SANFORD TRACY MEDICAL CENTER 251 FIFTH STREET EAST TRACY MN 56175 LYON 5076293200 241304 SANFORD MEDICAL CENTER WHEATON 401 12TH STREET NORTH WHEATON MN 56296 TRAVERSE 3205638226
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 110 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 241305 RIVERWOOD HEALTHCARE CENTER 200 BUNKER HILL DRIVE AITKIN MN 56431 AITKIN 2189275501 241306 RENVILLE COUNTY HOSPITAL AND CLINICS 100 HEALTHY WAY OLIVIA MN 56277 RENVILLE 3205231261 241308 LAKE VIEW MEMORIAL HOSPITAL 325 ELEVENTH AVE TWO HARBORS MN 55616 LAKE 2188347300 241309 ESSENTIA HEALTH SANDSTONE 109 COURT AVE SOUTH SANDSTONE MN 55072 PINE 3202452212 241311 RIDGEVIEW SIBLEY MEDICAL CENTER 601 WEST CHANDLER ARLINGTON MN 55307 SIBLEY 5079642271 241312 COOK HOSPITAL 10 SE FIFTH ST COOK MN 55723 ST. LOUIS 2186665945 241313 ESSENTIA HEALTH ADA 201 9TH STREET WEST ADA MN 56510 NORMAN 2187845000 241314 JOHNSON MEMORIAL HOSPITAL 1282 WALNUT STREET DAWSON MN 56232 LAC QUI PARLE 3207694323 241315 SANFORD JACKSON MEDICAL CENTER 1430 NORTH HIGHWAY JACKSON MN 56143 JACKSON 5078472420 241316 BIGFORK VALLEY HOSPITAL 258 PINE TREE DRIVE PO BOX 258 BIGFORK MN 56628 ITASCA 2187433177 241317 COOK COUNTY NORTHSHORE HOSPITAL 515 5TH AVE WEST GRAND MARAIS MN 55604 COOK 2183873040 241318 ELY BLOOMENSON COMMUNITY HOSPITAL 328 WEST CONAN STREET ELY MN 55731 ST. LOUIS 2183653271 241319 MURRAY COUNTY MEMORIAL HOSPITAL 2042 JUNIPER AVENUE SLAYTON MN 56172 MURRAY 5078361277 241320 RIVERVIEW HOSPITAL 323 SOUTH MINNESOTA CROOKSTON MN 56716 POLK 2182819200 241321 ESSENTIA HEALTH HOLY TRINITY HOSPITAL 115 SECOND STREET WEST, BOX 157 GRACEVILLE MN 56240 BIG STONE 3207488200 241322 RAINY LAKE MEDICAL CENTER 1400 HIGHWAY 71 INTERNATIONAL FALLS MN 56649 KOOCHICHING 2182835400 241323 MADELIA COMMUNITY HOSPITAL 121 DREW AVENUE SOUTHEAST MADELIA MN 56062 WATONWAN 5076423255 241325 CHIPPEWA COUNTY HOSPITAL 824 NORTH 11TH STREET MONTEVIDEO MN 56265 CHIPPEWA 3203218100 241326 CENTRACARE HEALTH SYSTEM ‐ LONG PRAIRIE 20 NINTH STREET SOUTHEAST LONG PRAIRIE MN 56347 TODD 3207322141 241327 SLEEPY EYE MUNICIPAL HOSPITAL 400 FOURTH AVENUE NORTHWEST SLEEPY EYE MN 56085 BROWN 5077943571 241328 SANFORD BAGLEY MEDICAL CENTER 203 4TH STREET NORTHWEST BAGLEY MN 56621 CLEARWATER 2186946501 241329 LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES MN 56479 TODD 2188941515 241330 CENTRACARE HEALTH SYSTEM ‐ MELROSE HOSPITAL 525 WEST MAIN STREET MELROSE MN 56352 STEARNS 3202564231 241332 WINDOM AREA HOSPITAL 2150 HOSPITAL DRIVE, PO BOX 339 WINDOM MN 56101 COTTONWOOD 5078312400 241333 MAYO CLINIC HEALTH SYSTEM ‐ ST JAMES 1101 MOULTON AND PARSONS DRIVE ST JAMES MN 56081 WATONWAN 5073753261 241334 RIVER'S EDGE HOSPITAL & CLINIC 1900 NORTH SUNRISE DRIVE ST PETER MN 56082 NICOLLET 5079347602 241335 ST ELIZABETH MEDICAL CENTER 1200 GRANT BLVD W WABASHA MN 55981 WABASHA 6515654531 241336 KITTSON MEMORIAL HOSPITAL 1010 SOUTH BIRCH HALLOCK MN 56728 KITTSON 2188433612 241337 NORTH VALLEY HEALTH CENTER 300 WEST GOOD SAMARITAN DRIVE WARREN MN 56762 MARSHALL 2187454211 241338 MAYO CLINIC HEALTH SYSTEM ‐ LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 WABASHA 6513451114
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 111 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 241339 HENDRICKS COMMUNITY HOSPITAL 503 E LINCOLN STREET HENDRICKS MN 56136 LINCOLN 5072753134 241340 ESSENTIA HEALTH NORTHERN PINES MEDICAL CENTER 5211 HIGHWAY 110 AURORA MN 55705 ST. LOUIS 2182294222
241341 APPLETON MUNICIPAL HOSPITAL 30 SOUTH BEHL STREET APPLETON MN 56208 SWIFT 3202898508 241342 ORTONVILLE AREA HEALTH SERVICES 450 EASTVOLD AVE ORTONVILLE MN 56278 BIG STONE 3208392502 241343 MUNICIPAL HOSPITAL AND GRANITE MANOR 345 TENTH AVENUE GRANITE FALLS MN 56241 YELLOW MEDICINE 3205643111 241344 LIFECARE MEDICAL CENTER 715 DELMORE DRIVE ROSEAU MN 56751 ROSEAU 2184632500 241345 MAYO CLINIC HEALTH SYSTEM ‐ WASECA 501 NORTH STATE STREET WASECA MN 56093 WASECA 5078351210 241346 MAYO CLINIC HEALTH SYSTEM ‐ CANNON FALLS 32021 COUNTY 24 BOULEVARD CANNON FALLS MN 55009 GOODHUE 5072636000 241347 SANFORD CANBY MEDICAL CENTER 112 ST OLAF AVENUE SOUTH CANBY MN 56220 YELLOW MEDICINE 5072237277 241348 AVERA TYLER HOSPITAL 240 WILLOW STREET TYLER MN 56178 LINCOLN 5072475521 241349 CENTRA CARE HEALTH PAYNESVILLE 200 1ST STREET WEST PAYNESVILLE MN 56362 STEARNS 3202433779 241350 MERCY HOSPITAL 4572 COUNTY ROAD 61 MOOSE LAKE MN 55767 CARLTON 2184854481 241351 REDWOOD AREA HOSPITAL 100 FALLWOOD ROAD REDWOOD FALLS MN 56283 REDWOOD 5076374500 241352 MAYO CLINIC HEALTH SYSTEM ‐ SPRINGFIELD 625 JACKSON AVENUE NORTH SPRINGFIELD MN 56087 BROWN 5077236201 241353 CUYUNA REGIONAL MEDICAL CENTER 320 EAST MAIN STREET CROSBY MN 56441 CROW WING 2185467000 241354 TRI COUNTY HOSPITAL 415 JEFFERSON STREET NORTH WADENA MN 56482 WADENA 2186313510 241355 GLENCOE REGIONAL HEALTH SERVICES 1805 HENNEPIN AVENUE NORTH GLENCOE MN 55336 MCLEOD 3208643121 241356 MILLE LACS HEALTH SYSTEM 200 NORTH ELM STREET ONAMIA MN 56359 MILLE LACS 3205323154 241357 ESSENTIA HEALTH FOSSTON 900 HILLIGOSS BOULEVARD SE FOSSTON MN 56542 POLK 2184351133 241358 CASS LAKE INDIAN HEALTH SERVICES HOSPITAL 425 7TH STREET NW CASS LAKE MN 56633 CASS 2183353200 241359 AVERA MARSHALL REGIONAL MEDICAL CTR 300 SOUTH BRUCE STREET MARSHALL MN 56258 LYON 5075329661 241360 DEER RIVER HEALTHCARE CENTER 115 10TH AVENUE NORTHEAST DEER RIVER MN 56636 ITASCA 2182462900 241361 MAYO CLINIC HEALTH SYSTEM ‐ NEW PRAGUE 301 2ND STREET NORTHEAST NEW PRAGUE MN 56071 SCOTT 9527588101 241362 CENTRACARE HEALTH ‐ MONTICELLO 1013 HART BOULEVARD MONTICELLO MN 55362 WRIGHT 7632952945 241363 STEVENS COMMUNITY MEDICAL CENTER 400 EAST FIRST STREET, PO BOX 660 MORRIS MN 56267 STEVENS 3205891313 241364 COMMUNITY MEMORIAL HOSPITAL 512 SKYLINE BOULEVARD CLOQUET MN 55720 CARLTON 2188794641 241365 SWIFT COUNTY BENSON HOSPITAL 1815 WISCONSIN AVENUE BENSON MN 56215 SWIFT 3208434232 241366 MEEKER MEMORIAL HOSPITAL 612 SOUTH SIBLEY AVENUE LITCHFIELD MN 55355 MEEKER 3206933242 241367 FIRSTLIGHT HEALTH SYSTEM 301 SOUTH HIGHWAY 65 MORA MN 55051 KANABEC 3202253315
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 112 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 241368 CENTRACARE HEALTH SYSTEM ‐ SAUK CENTRE 425 NORTH ELM STREET SAUK CENTRE MN 56378 STEARNS 3203522221 241369 UNITED HOSPITAL DISTRICT 515 SOUTH MOORE STREET, PO BOX 160 BLUE EARTH MN 56013 FARIBAULT 5075263273 241370 ST GABRIELS HOSPITAL 815 SOUTHEAST SECOND STREET LITTLE FALLS MN 56345 MORRISON 3206325441 241371 SANFORD LUVERNE MEDICAL CENTER 1600 NORTH KNISS AVENUE P O BOX 1019 LUVERNE MN 56156 ROCK 5072832321 241372 MADISON HOSPITAL 820 THIRD AVENUE MADISON MN 56256 LAC QUI PARLE 3206987141 241373 PERHAM HEALTH 1000 CONEY STREET WEST PERHAM MN 56573 OTTER TAIL 2183474500 241374 PIPESTONE COUNTY MEDICAL CENTER 916 4TH AVENUE SOUTHWEST PIPESTONE MN 56164 PIPESTONE 5078255811 241375 MINNESOTA VALLEY HEALTH CENTER INC 621 SOUTH FOURTH STREET LE SUEUR MN 56058 LE SUEUR 5076653375 241376 GLACIAL RIDGE HOSPITAL 10 4TH AVENUE SOUTHEAST GLENWOOD MN 56334 POPE 3206344521 241377 ST FRANCIS MEDICAL CENTER 2400 ST FRANCIS DRIVE BRECKENRIDGE MN 56520 WILKIN 2186433000 241378 NEW ULM MEDICAL CENTER 1324 FIFTH NORTH STREET NEW ULM MN 56073 BROWN 5072331000 241379 PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES 1411 STATE HIGHWAY 793 ELBOW LAKE MN 56531 GRANT 2186854461 241380 ST JOSEPHS AREA HEALTH SERVICES 600 PLEASANT AVENUE PARK RAPIDS MN 56470 HUBBARD 2187323311 241381 SANFORD MEDICAL CENTER THIEF RIVER FALLS 3001 SANFORD PARKWAY THIEF RIVER FALLS MN 56701 PENNINGTON 2186814240 241991 BEACON HAVEN 1200 LONG LAKE ROAD NEW BRIGHTON MN 55112 RAMSEY 6513790100 242004 HEALTHEAST BETHESDA HOSPITAL 559 CAPITOL BOULEVARD SAINT PAUL MN 55103 RAMSEY 6512322000 242005 REGENCY HOSPITAL OF MINNEAPOLIS LLC 1300 HIDDEN LAKES PARKWAY GOLDEN VALLEY MN 55422 HENNEPIN 7633028301 243300 GILLETTE CHILDRENS SPECIALTY HOSPITAL 200 UNIVERSITY AVENUE EAST SAINT PAUL MN 55106 RAMSEY 6122912848 243302 CHILDREN'S HOSPITALS & CLINICS OF MN 2525 CHICAGO AVENUE SOUTH MINNEAPOLIS MN 55404 HENNEPIN 6128136112 243303 SHRINERS HOSPITALS FOR CHILDREN ‐ TWIN CITIES 2025 EAST RIVER PARKWAY MINNEAPOLIS MN 55414 HENNEPIN 6125966100 244002 ANOKA‐METRO REG TREATMENT CTR 3301 SEVENTH AVE NORTH ANOKA MN 55303 ANOKA 6514315000 244005 CHILD & ADOLESCENT BEHAVIORAL HEALTH SERVICES 1701 TECHNOLOGY DRIVE NE WILLMAR MN 56201 KANDIYOHI 3202315421
244010 COMM BEHAVIORAL HEALTH HOSP ‐ ST PETER 2000 KLEIN STREET SAINT PETER MN 56082 NICOLLET 5079335001 244011 COMMUNITY BEHAVIORAL HEALTH HOSPITAL ANNANDALE 400 ANNANDALE BOULEVARD ANNANDALE MN 55302 WRIGHT 7632385740
244012 COMM BEHAVIORAL HEALTH HOSP 1610 8TH AVENUE EAST ALEXANDRIA MN 56308 DOUGLAS 3203356201 244013 COMMUNITY BEHAVIORAL HOSPITAL FERGUS FALLS 1801 WEST ALCOTT FERGUS FALLS MN 56537 OTTER TAIL 2183325001 244014 COMMUNITY BEHAVIORAL HEALTH HOSPITAL ‐ BEMIDJI 800 BEMIDJI AVENUE NORTH SUITE 200 BEMIDJI MN 56601 BELTRAMI 2183082401
244015 COMMUNITY BEHAVIORAL HEALTH HOSPITAL ‐ BAXTER 14241 GRAND OAKS DRIVE BAXTER MN 56425 CROW WING 2183082401
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 113 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 244016 PRAIRIECARE 12915 63RD AVENUE NORTH MAPLE GROVE MN 55369 HENNEPIN 7633835800 244017 COMMUNITY BEHAVIORAL HEALTH HOSPITAL ROCHESTER 251 WOOD LAKE DRIVE SOUTHEAST ROCHESTER MN 55904 OLMSTED 5072062562
244018 SANFORD BEHAVIORAL HEALTH CENTER 120 LABREE AVENUE SOUTH THIEF RIVER FALLS MN 56701 PENNINGTON 2186814240 249801 MAYO CLINIC METHODIST HOSPITAL 201 WEST CENTER STREET ROCHESTER MN 55902 OLMSTED 5072667890 249802 ABBOTT NORTHWESTERN ORGAN TRANSPLANT HOSPITAL 800 EAST 28TH STREET MINNEAPOLIS MN 55407 HENNEPIN 6128634000
249803 ST MARYS HOSPITAL ORGAN TRANSPLANT 1216 SECOND STREET SOUTHWEST ROCHESTER MN 55902 OLMSTED 5072555123 249804 UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55455 HENNEPIN 6122736150
249805 HENNEPIN COUNTY MEDICAL CENTER 701 PARK AVE MINNEAPOLIS MN 55415 HENNEPIN 6128739393 250001 UNIVERSITY OF MISSISSIPPI MED CENTER 2500 N STATE ST JACKSON MS 39216 HINDS 6019844100 250002 TISHOMINGO HEALTH SERVICES INC 1777 CURTIS DRIVE IUKA MS 38852 TISHOMINGO 6624236051 250004 NORTH MISSISSIPPI MEDICAL CENTER 830 S GLOSTER TUPELO MS 38801 LEE 6623773000 250006 BAPTIST MEMORIAL HOSPITAL UNION COUNTY 200 HWY 30 WEST NEW ALBANY MS 38652 UNION 6625387631 250007 MERIT HEALTH BILOXI 150 REYNOIR STREET BILOXI MS 39530 HARRISON 2284361104 250009 MAGNOLIA REGIONAL HEALTH CENTER 611 ALCORN DRIVE CORINTH MS 38834 ALCORN 6622931000 250012 ALLIANCE HEALTHCARE SYSTEM 1430 HIGHWAY 4 EAST / P O BOX 6000 HOLLY SPRINGS MS 38635 MARSHALL 6622521212 250017 TRACE REGIONAL HOSP AND SWING BED 1002 EAST MADISON STREET HOUSTON MS 38851 CHICKASAW 6624563700 250018 JASPER GENERAL HOSPITAL 15 SOUTH 6TH STREET BAY SPRINGS MS 39422 JASPER 6017642101 250019 MEMORIAL HOSPITAL AT GULFPORT 4500 13TH ST‐P O BOX 1810 GULFPORT MS 39502 HARRISON 2288674000 250020 WEBSTER GENERAL HOSPITAL/ SWING BED 70 MEDICAL PLAZA EUPORA MS 39744 WEBSTER 6622586221 250025 MERIT HEALTH GILMORE MEMORIAL 1105 EARL FRYE BLVD / PO BOX 459 AMORY MS 38821 MONROE 6622566002 250027 WINSTON MEDICAL CENTER & SWINGBED 923 SOUTH CHRUCH STREET LOUISVILLE MS 39339 WINSTON 6627795124 250031 MERIT HEALTH RIVER REGION 2100 HWY 61 N VICKSBURG MS 39183 WARREN 6018835000 250034 BAPTIST MEMORIAL HOSPITAL NORTH MS 2301 SOUTH LAMAR OXFORD MS 38655 LAFAYETTE 6622328100 250036 GEORGE REGIONAL HEALTH SYSTEM 859 WINTER STREET LUCEDALE MS 39452 GEORGE 6019473161 250038 MERIT HEALTH MADISON 161 RIVER OAKS DRIVE CANTON MS 39046 MADISON 6018554000 250040 SINGING RIVER HOSPITAL 2809 DENNY AV PASCAGOULA MS 39581 JACKSON 2288095000 250042 NORTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER 1970 HOSPITAL DRIVE CLARKSDALE MS 38614 COAHOMA 6626273211
250043 NESHOBA COUNTY GENERAL HOSPITAL 1001 HOLLAND AVENUE PHILADELPHIA MS 39350 NESHOBA 6016631200
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 114 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 250044 BAPTIST MEMORIAL HOSPITAL BOONEVILLE 100 HOSPITAL DRIVE BOONEVILLE MS 38829 PRENTISS 6627205000 250048 ST DOMINIC‐JACKSON MEMORIAL HOSPITAL 969 LAKELAND DR JACKSON MS 39216 HINDS 6012002000 250049 BEACHAM MEMORIAL HOSPITAL 205 N CHERRY STREET MAGNOLIA MS 39652 PIKE 6017832353 250050 OCH REGIONAL MEDICAL CENTER 400 HOSPITAL ROAD /MAIL PO BOX 1506 STARKVILLE MS 39759 OKTIBBEHA 6623234320 250057 KING'S DAUGHTERS MEDICAL CENTER‐BROOKHAVEN P O BOX 948/427 HIGHWAY 51 NORTH BROOKHAVEN MS 39601 LINCOLN 6018336011 250058 SOUTH CENTRAL REG MED CTR 1220 JEFFERSON ST BOX 607 LAUREL MS 39440 JONES 6014264000 250060 JEFFERSON COUNTY HOSPITAL 870 S MAIN FAYETTE MS 39069 JEFFERSON 6017863401 250061 YALOBUSHA GENERAL HOSPITAL 630 SOUTH MAIN STREET WATER VALLEY MS 38965 YALOBUSHA 6624731411 250067 CLAY COUNTY MEDICAL CENTER 835 MEDICAL CENTER DR WEST POINT MS 39773 CLAY 6624952300 250069 RUSH FOUNDATION HOSPITAL 1314 19TH AVE MERIDIAN MS 39301 LAUDERDALE 6014830011 250072 MERIT HEALTH CENTRAL 1850 CHADWICK DR JACKSON MS 39204 HINDS 6013761000 250077 WAYNE GENERAL HOSPITAL 950 MATTHEW DR WAYNESBORO MS 39367 WAYNE 6017355151 250078 FORREST GENERAL HOSPITAL 6051 US HIGHWAY 49 HATTIESBURG MS 39404 FORREST 6012887000 250079 SHARKEY ISSAQUENA COMMUNITY HOSPITAL 47 SOUTH FOURTH ST ROLLING FORK MS 39159 SHARKEY 6628734395 250081 ANDERSON RMC SOUTH 1102 CONSTITUTION AVENUE MERIDIAN MS 39301 LAUDERDALE 6014843590 250082 DELTA REGIONAL MEDICAL CENTER 1400 E UNION ST GREENVILLE MS 38704 WASHINGTON 6623783783 250084 MERIT HEALTH NATCHEZ 52 SERGEANT PRENTISS DRIVE NATCHEZ MS 39120 ADAMS 6014432100 250085 MARION GENERAL HOSPITAL 1560 SUMRALL RD COLUMBIA MS 39429 MARION 6017366303 250093 BOLIVAR MEDICAL CENTER 901 E SUNFLOWER RD CLEVELAND MS 38732 BOLIVAR 6628460061 250094 MERIT HEALTH WESLEY 5001 W HARDY ST HATTIESBURG MS 39402 FORREST 6012688000 250095 SOUTH SUNFLOWER COUNTY HOSPITAL 121 E BAKER ST INDIANOLA MS 38751 SUNFLOWER 6628875235 250096 MERIT HEALTH RANKIN 350 CROSSGATES BLVD BRANDON MS 39042 RANKIN 6018252811 250097 SOUTHWEST MS REGIONAL MEDICAL CENTER 215 MARION AV BOX 1307 MCCOMB MS 39649 PIKE 6012495500 250099 GREENWOOD LEFLORE HOSPITAL 1401 RIVER RD / PO BOX 1410 GREENWOOD MS 38930 LEFLORE 6624597000 250100 BAPTIST MEM HOSP/ GOLDEN TRIANGLE INC 2520 5TH ST N COLUMBUS MS 39701 LOWNDES 6622441500 250102 MISSISSIPPI BAPTIST MEDICAL CENTER 1225 N STATE ST JACKSON MS 39202 HINDS 6019681000 250104 ANDERSON REGIONAL MEDICAL CTR 2124 14 ST MERIDIAN MS 39301 LAUDERDALE 6015536000 250117 HIGHLAND COMMUNITY HOSPITAL 130 HIGHLAND PKWY PICAYUNE MS 39466 PEARL RIVER 6013589400 250123 GARDEN PARK MEDICAL CENTER 15200 COMMUNITY ROAD GULFPORT MS 39503 HARRISON 2285757000 250124 MAGEE GENERAL HOSPITAL 300 3RD AVE SE MAGEE MS 39111 SIMPSON 6018495070
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 115 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 250126 NORTH OAK REGIONAL MEDICAL CENTER 401 GETWELL DR SENATOBIA MS 38668 TATE 6625623100 250127 CHOCTAW HEALTH CENTER ROUTE 7 BOX R50 PHILADELPHIA MS 39350 NESHOBA 6016562211 250128 MERIT HEALTH BATESVILLE 303 MEDICAL CENTER DRIVE BATESVILLE MS 38606 PANOLA 6625635611 250134 WHITFIELD MEDICAL SURGICAL HOSPITAL 3550 HWY 468 W, BLDG 60 WHITFIELD MS 39193 RANKIN 6013518023 250136 MERIT HEALTH WOMEN'S HOSPITAL 1026 RIVER OAKS DRIVE FLOWOOD MS 39232 RANKIN 6019321000 250138 MERIT HEALTH RIVER OAKS 1030 RIVER OAKS DRIVE FLOWOOD MS 39232 RANKIN 6019321030 250141 BAPTIST MEMORIAL HOSPITAL DESOTO 7601 SOUTHCREST PARKWAY SOUTHAVEN MS 38671 DESOTO 6627724000 250151 ALLIANCE HEALTH CENTER 5000 HIGHWAY 39 NORTH MERIDIAN MS 39301 LAUDERDALE 6014836211 250152 MISSISSIPPI METHODIST REHAB CTR 1350 E WOODROW WILSON DR JACKSON MS 39216 HINDS 6019812611 250159 ALLIANCE LAIRD HOSPITAL 25117 HIGHWAY 15 UNION MS 39365 NEWTON 6017748214 250162 HANCOCK MEDICAL CENTER 149 DRINKWATER BLVD BAY SAINT LOUIS MS 39521 HANCOCK 2284678600 250163 PATIENTS CHOICE MEDICAL CENTER 347 MAGNOLIA DRIVE RALEIGH MS 39153 SMITH 6017829997 250167 METHODIST HEALTHCARE ‐ OLIVE BRANCH HOSPITAL 4250 BETHEL ROAD OLIVE BRANCH MS 38654 DESOTO 6629329000 250168 UNIVERSITY OF MISSISSIPPI MEDICAL CENTER‐ GRENADA 960 AVENT DRIVE GRENADA MS 38901 GRENADA 6622277000
25039F US AIR FORCE HOSP KEELSER AFB BILOXI MS 39534 HARRISON 25041F US AIR FORCE HOSP COLUMBUS AFB COLUMBUS MS 39701 LOWNDES 25042F VA MEDICAL CENTER GULFPORT 200 E BEACH BLVD GULFPORT MS 39507 HARRISON 2288672865 25043F GV MONTGOMERY VA MEDICAL CENTER 1500 E WOODROW WILSON DR JACKSON MS 39216 HINDS 6013624471 25063E DOCTORS HOSP‐ 2949 UNIVERSITY AVE JACKSON MS 39216 HINDS 25077F US PUBLIC HEALTH SERVICE INDIAN HOSP ROUTE 3 PHILADELPHIA MS 39350 NESHOBA 25078E MC COMB CITY HOSP MARYLAND AVE MC COMB MS 39648 PIKE 25086E EYE EAR NOSE & THROAT HOSP 3017 13TH ST GULFPORT MS 39501 HARRISON 25092E NATCHEZ CHARITY HOSP‐ 129 JEFF DAVIS BLVD NATCHEZ MS 39120 ADAMS 25100E RIVERSIDE HOSP P O BOX 4297 JACKSON MS 39216 HINDS 251300 LACKEY MEMORIAL HOSPITAL 330 N BROAD STREET FOREST MS 39074 SCOTT 6014694151 251302 PIONEER COMMUNITY HOSPITAL OF ABERDEEN 400 S CHESTNUT STREET ABERDEEN MS 39730 MONROE 6623692455 251303 STONE COUNTY HOSPITAL 1434 EAST CENTRAL AVENUE WIGGINS MS 39577 STONE 6019286600 251304 TALLAHATCHIE CRITICAL ACCESS HOSPITAL 201 SOUTH MARKET ST / PO BOX 230 CHARLESTON MS 38921 TALLAHATCHIE 6626475535 251305 LAWRENCE COUNTY HOSPITAL CAH 1065 EAST BROAD ST MONTICELLO MS 39654 LAWRENCE 6015874051
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 116 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 251306 PERRY COUNTY GENERAL HOSP 206 BAY ST RICHTON MS 39476 PERRY 6017886316 251307 NOXUBEE GENERAL CRITICAL ACCESS HOSP 606 NORTH JEFFERSON STREET MACON MS 39341 NOXUBEE 6627264231 251308 PONTOTOC HEALTH SERVICE CAH 176 SOUTH MAIN STREET PONTOTOC MS 38863 PONTOTOC 6624895510 251309 FIELD HEALTH SYSTEM 178 HIGHWAY 24 CENTREVILLE MS 39631 WILKINSON 6018900500 251312 TYLER HOLMES MEMORIAL HOSPITAL CAH 409 TYLER HOLMES DRIVE WINONA MS 38967 MONTGOMERY 6622834114 251313 BAPTIST MEDICAL CENTER YAZOO 823 GRAND AVENUE YAZOO CITY MS 39194 YAZOO 6627462261 251314 QUITMAN COUNTY HOSPITAL CAH 340 GETWELL DRIVE MARKS MS 38646 QUITMAN 6623268031 251315 BAPTIST MEDICAL CENTER‐LEAKE 1100 HIGHWAY 16 EAST CARTHAGE MS 39051 LEAKE 6012671422 251316 H C WATKINS MEMORIAL HOSPITAL INC 605 SOUTH ARCHUSA AVENUE QUITMAN MS 39355 CLARKE 6017766925 251317 SIMPSON GENERAL HOSPITAL CAH 1842 SIMPSON HIGHWAY 149 MENDENHALL MS 39114 SIMPSON 6018472221 251318 NORTH SUNFLOWER MEDICAL CENTER CAH 840 NORTH OAK AVENUE RULEVILLE MS 38771 SUNFLOWER 6627562711 251319 HOLMES COUNTY HOSPITAL AND CLINICS 239 BOWLING GREEN ROAD LEXINGTON MS 39095 HOLMES 6628341321 251320 CLAIBORNE COUNTY HOSPITAL 123 MCCOMB AVENUE PORT GIBSON MS 39150 CLAIBORNE 6014375141 251322 LAIRD HOSPITAL INC 25117 HIGHWAY 15 UNION MS 39365 NESHOBA 6017748214 251323 SCOTT REGIONAL HOSPITAL CAH 317 HIGHWAY 13 SOUTH MORTON MS 39117 SCOTT 6017326301 251324 WALTHALL COUNTY GENERAL HOSPITAL CAH 100 HOSPITAL DRIVE TYLERTOWN MS 39667 WALTHALL 6018762122 251325 COVINGTON COUNTY HOSPITAL CAH 701 SOUTH HOLLY AVENUE COLLINS MS 39428 COVINGTON 6017656711 251326 JEFFERSON DAVIS COMMUNITY HOSPITAL CAH 1102 ROSE STREET PRENTISS MS 39474 JEFFERSON DAVIS 6017924276 251327 HARDY WILSON MEMORIAL HOSPITAL CAH 233 MAGNOLIA STREET HAZLEHURST MS 39083 COPIAH 6018944541 251329 GREENE COUNTY HOSPITAL CAH 1017 JACKSON STREET LEAKESVILLE MS 39451 GREENE 6013944135 251330 FRANKLIN COUNTY MEMORIAL HOSPITAL 40 UNION CHURCH RD MEADVILLE MS 39653 FRANKLIN 6013845801 251331 CALHOUN HEALTH SERVICES 140 BURKE‐CALHOUN CITY ROAD CALHOUN CITY MS 38916 CALHOUN 6626286611 251332 PIONEER HEALTH SERVICES OF NEWTON 9421 EAST SIDE DRIVE EXTENSION, POB 299 NEWTON MS 39345 NEWTON 6016832031 251333 PEARL RIVER COUNTY HOSPITAL 305 WEST MOODY STREET POPLARVILLE MS 39470 PEARL RIVER 6017954543 251334 CHOCTAW REGIONAL MEDICAL CENTER 8613 MS HWY 12 ACKERMAN MS 39735 CHOCTAW 6622854400 251335 JOHN C STENNIS MEMORIAL HOSPITAL 14365 HIGHWAY 16 WEST DE KALB MS 39328 KEMPER 7694861000 251336 BAPTIST MEDICAL CENTER ‐ ATTALA 220 HWY 12 WEST KOSCIUSKO MS 39090 ATTALA 6622894311 251337 TIPPAH COUNTY HOSPITAL 1005 CITY AVE NORTH RIPLEY MS 38663 TIPPAH 6628379221 252003 SELECT SPECIALTY HOSPITAL ‐ BELHAVEN 1225 NORTH STATE STREET JACKSON MS 39202 HINDS 6019681050 252004 SPECIALITY HOSPITAL OF MERIDIAN,THE 1314 19TH AVENUE MERIDIAN MS 39301 LAUDERDALE 6017034211
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 117 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 252005 SELECT SPECIALTY HOSPITAL‐GULF COAST, INC 1520 BROAD AVENUE SUITE 300 GULFPORT MS 39501 HARRISON 2285757500 252006 REGENCY HOSPITAL OF MERIDIAN 1102 CONSTITUTION AVENUE, 2ND FLOOR MERIDIAN MS 39301 LAUDERDALE 6014847900 252007 SELECT SPECIALTY HOSPITAL JACKSON 5903 RIDGEWOOD ROAD JACKSON MS 39211 HINDS 6018993800 252008 PROMISE HOSPITAL OF VICKSBURG, INC 1111 NORTH FRONTAGE ROAD 2D FLOOR VICKSBURG MS 39180 WARREN 6018833439 252009 REGENCY HOSPITAL OF HATTIESBURG 6051 US HIGHWAY 49 5TH FLOOR HATTIESBURG MS 39404 FORREST 6012888510 252010 GREENWOOD ‐ AMG SPECIALTY HOSPITAL 1401 RIVER ROAD 2D FLOOR GREENWOOD MS 38930 LEFLORE 6624515172 252012 REGENCY HOSPITAL OF JACKSON, LLC 969 LAKELAND DRIVE, 6TH FLOOR JACKSON MS 39216 HINDS 6013646200 252013 ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE 300 SOUTH WASHINGTON AVE, 3RD FLOOR GREENVILLE MS 38701 WASHINGTON 6623327344 254005 PARKWOOD BEHAVIORAL HEALTH SYSTEM 8135 GOODMAN ROAD OLIVE BRANCH MS 38654 DESOTO 6628954900 254007 BRENTWOOD BEHAVIORAL HEALTHCARE OF MS 3531 EAST LAKELAND DRIVE FLOWOOD MS 39232 RANKIN 6019362024 254008 SOUTH MISSISSIPPI STATE HOSPITAL 823 HIGHWAY 589 PURVIS MS 39475 LAMAR 6017940100 254009 NORTH MISSISSIPPI STATE HOSPITAL 1937 BRIAR RIDGE RD TUPELO MS 38804 LEE 6626904200 254010 MS STATE HOSPITAL‐WHITFIELD 3550 HIGHWAY 468 WEST WHITFIELD MS 39193 RANKIN 6013518000 259800 UNIVERSITY OF MISSISSIPPI MEDICAL CENTER 2500 N STATE STREET JACKSON MS 39216 HINDS 6019844100 260001 MERCY HOSPITAL JOPLIN 100 MERCY WAY JOPLIN MO 64804 JASPER 4177812727 260004 COOPER COUNTY MEMORIAL HOSPITAL 17651 B HWY BOONVILLE MO 65233 COOPER 6608827461 260005 SSM HEALTH ST JOSEPH HOSPITAL‐ST CHARLES 300 1ST CAPITOL DR SAINT CHARLES MO 63301 ST. CHARLES 6369475000 260006 MOSAIC LIFE CARE AT ST JOSEPH 5325 FARAON STREET SAINT JOSEPH MO 64506 BUCHANAN 8162716000 260009 BOTHWELL REGIONAL HEALTH CENTER 601 E 14TH ST SEDALIA MO 65302 PETTIS 6608268833 260011 SSM HEALTH ST. MARY'S HOSPITAL ‐ JEFFERSON CITY 2505 MISSION DRIVE JEFFERSON CITY MO 65109 COLE 5736813000 260015 TWIN RIVERS REGIONAL MEDICAL CENTER 1301 FIRST ST KENNETT MO 63857 DUNKLIN 5738884522 260017 PHELPS COUNTY REGIONAL MEDICAL CENTER 1000 W 10TH ST ROLLA MO 65401 PHELPS 5734588899 260020 MERCY HOSPITAL ST LOUIS 615 NEW BALLAS ROAD SAINT LOUIS MO 63141 ST. LOUIS 3145696000 260022 NORTHEAST REGIONAL MEDICAL CENTER 315 S OSTEOPATHY KIRKSVILLE MO 63501 ADAIR 6607851000 260023 MERCY HOSPITAL JEFFERSON 1400 HIGHWAY 61 SOUTH CRYSTAL CITY MO 63019 JEFFERSON 6369331000 260024 TEXAS COUNTY MEMORIAL HOSPITAL 1333 SAM HOUSTON BOULEVARD HOUSTON MO 65483 TEXAS 4179673311 260025 HANNIBAL REGIONAL HOSPITAL 6000 HOSPITAL DR HANNIBAL MO 63401 MARION 5732481300 260027 RESEARCH MEDICAL CENTER 2316 E MEYER BLVD KANSAS CITY MO 64132 JACKSON 8162764000 260032 BARNES JEWISH HOSPITAL ONE BARNES‐JEWISH HOSPITAL PLAZA SAINT LOUIS MO 63110 3147473000 260034 BATES COUNTY MEMORIAL HOSPITAL 615 W NURSERY ST BUTLER MO 64730 BATES 6602007000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 118 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 260040 COX MEDICAL CENTERS 3801 SOUTH NATIONAL AVENUE SPRINGFIELD MO 65807 GREENE 4172696000 260047 CAPITAL REGION MEDICAL CENTER 1125 MADISON ST JEFFERSON CITY MO 65102 COLE 5736325000 260048 TRUMAN MEDICAL CENTER HOSPITAL HILL 2301 HOLMES STREET KANSAS CITY MO 64108 JACKSON 8164041000 26004F VA HOSP 4801 LINWOOD BLVD KANSAS CITY MO 64128 JACKSON 8169223303 260050 SSM HEALTH ST FRANCIS HOSPITAL ‐ MARYVILLE 2016 SOUTH MAIN ST MARYVILLE MO 64468 NODAWAY 6605622600 260052 MERCY HOSPITAL WASHINGTON 901 EAST 5TH STREET WASHINGTON MO 63090 FRANKLIN 6362398000 260057 CAMERON REGIONAL MEDICAL CENTER 1600 E EVERGREEN CAMERON MO 64429 CLINTON 8166322101 260059 MERCY HOSPITAL LEBANON 100 HOSPITAL DRIVE LEBANON MO 65536 LACLEDE 4175336100 260061 NEVADA REGIONAL MEDICAL CENTER 800 S ASH ST NEVADA MO 64772 VERNON 4176673355 260062 SAINT LUKES NORTHLAND HOSPITAL 5830 N W BARRY ROAD KANSAS CITY MO 64154 PLATTE 8168916000 260064 SSM HEALTH ST. MARY'S HOSPITAL‐AUDRAIN 620 E MONROE MEXICO MO 65265 AUDRAIN 5735825000 260065 MERCY HOSPITAL SPRINGFIELD 1235 E CHEROKEE SPRINGFIELD MO 65804 GREENE 4178202000 260068 BOONE HOSPITAL CENTER 1600 E BROADWAY COLUMBIA MO 65201 BOONE 5738158000 260070 PEMISCOT COUNTY MEMORIAL HOSPITAL 946 EAST REED HAYTI MO 63851 PEMISCOT 5733591372 260074 MOBERLY REGIONAL MEDICAL CENTER 1515 UNION AVE MOBERLY MO 65270 RANDOLPH 6602638400 260077 ST ANTHONY'S MEDICAL CENTER 10010 KENNERLY ROAD SAINT LOUIS MO 63128 ST. LOUIS 3145251000 260078 OZARKS MEDICAL CENTER 1100 KENTUCKY AVE WEST PLAINS MO 65775 HOWELL 4172569111 260080 SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY 109 PLUM ST DONIPHAN MO 63935 RIPLEY 5739962141 260081 SSM HEALTH ST CLARE HOSPITAL ‐ FENTON 1015 BOWLES FENTON MO 63026 JEFFERSON 6364962000 260085 ST JOSEPH MEDICAL CENTER 1000 CARONDELET DR KANSAS CITY MO 64114 JACKSON 8169424000 260091 SSM HEALTH ST MARY'S HOSPITAL ‐ ST LOUIS 6420 CLAYTON RD RICHMOND HEIGHTS MO 63117 ST. LOUIS 3147688000 260094 COX MEDICAL CENTER BRANSON 525 BRANSON LANDING BLVD, PO BOX 650 BRANSON MO 65615 TANEY 4173357000 260095 CENTERPOINT MEDICAL CENTER 19600 EAST 39TH STREET INDEPENDENCE MO 64057 JACKSON 8166987000 260096 NORTH KANSAS CITY HOSPITAL 2800 CLAY EDWARDS DRIVE NORTH KANSAS CITY MO 64116 CLAY 8166912000 260097 WESTERN MISSOURI MEDICAL CENTER 403 BURKARTH ROAD WARRENSBURG MO 64093 JOHNSON 6607472500 260102 TRUMAN MEDICAL CENTER LAKEWOOD 7900 LEE'S SUMMIT RD KANSAS CITY MO 64139 JACKSON 8164047000 260104 SSM HEALTH DEPAUL HOSPITAL ST LOUIS 12303 DEPAUL DRIVE BRIDGETON MO 63044 ST. LOUIS 3143446000 260105 SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL 3635 VISTA AVE SAINT LOUIS MO 63110 3145778000 260108 MISSOURI BAPTIST MEDICAL CENTER 3015 N BALLAS RD TOWN AND COUNTRY MO 63131 ST. LOUIS 3149965000 260110 SOUTHEASTHEALTH 1701 LACEY ST CAPE GIRARDEAU MO 63701 CAPE GIRARDEAU 5733344822
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 119 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 260113 MISSOURI DELTA MEDICAL CENTER 1008 NORTH MAIN ST SIKESTON MO 63801 NEW MADRID 5734711600 260119 POPLAR BLUFF REGIONAL MEDICAL CENTER 3100 OAK GROVE ROAD POPLAR BLUFF MO 63901 BUTLER 5737857721 260137 FREEMAN HEALTH SYSTEM ‐ FREEMAN WEST 1102 WEST 32ND STREET JOPLIN MO 64804 JASPER 4173471111 260138 ST LUKES HOSPITAL OF KANSAS CITY 4401 WORNALL ROAD KANSAS CITY MO 64111 JACKSON 8169322000 260141 UNIVERSITY OF MISSOURI HEALTH CARE ONE HOSPITAL DRIVE COLUMBIA MO 65212 BOONE 5738824141 260142 FITZGIBBON HOSPITAL 2305 S 65 HIGHWAY MARSHALL MO 65340 SALINE 6608867431 260160 SOUTHEASTHEALTH CENTER OF STODDARD COUNTY 1200 N ONE MILE RD DEXTER MO 63841 STODDARD 5736245566 260162 BARNES‐JEWISH WEST COUNTY HOSPITAL 12634 OLIVE BOULEVARD CREVE COEUR MO 63141 ST. LOUIS 3149968000 260163 PARKLAND HEALTH CENTER 1101 W LIBERTY FARMINGTON MO 63640 ST. FRANCOIS 5734316005 260175 GOLDEN VALLEY MEMORIAL HOSPITAL 1600 N 2ND ST CLINTON MO 64735 HENRY 6608855511 260176 DES PERES HOSPITAL 2345 DOUGHERTY FERRY ROAD SAINT LOUIS MO 63122 ST. LOUIS 3149669100 260177 LIBERTY HOSPITAL 2525 GLENN HENDREN DR LIBERTY MO 64069 CLAY 8167817200 260179 ST LUKES HOSPITAL 232 S WOODS MILL RD CHESTERFIELD MO 63017 ST. LOUIS 3144341500 26017E SHRINERS HOSP FOR CRIPPLED CHILDREN 2001 S LINDBERGH BLVD SAINT LOUIS MO 63131 ST. LOUIS 3144323600 260180 CHRISTIAN HOSPITAL NORTHEAST‐NORTHWEST 11133 DUNN ROAD SAINT LOUIS MO 63136 ST. LOUIS 3146535000 260183 SAINT FRANCIS MEDICAL CENTER 211 ST FRANCIS DR CAPE GIRARDEAU MO 63703 CAPE GIRARDEAU 5733313000 260186 LAKE REGIONAL HEALTH SYSTEM 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 CAMDEN 5733488000 260190 LEE'S SUMMIT MEDICAL CENTER 2100 SE BLUE PARKWAY LEES SUMMIT MO 64063 JACKSON 8162825000 260191 BARNES‐JEWISH ST PETERS HOSPITAL 10 HOSPITAL DR SAINT PETERS MO 63376 ST. CHARLES 6369169000 260193 ST MARY'S MEDICAL CENTER 201 NW R D MIZE RD BLUE SPRINGS MO 64014 JACKSON 8162285900 260195 CITIZENS MEMORIAL HOSPITAL 1500 N OAKLAND BOLIVAR MO 65613 POLK 4173266000 260200 SSM HEALTH SAINT JOSEPH HOSPITAL‐LAKE SAINT LOUIS 100 MEDICAL PLAZA LAKE SAINT LOUIS MO 63367 ST. CHARLES 6366255200
260207 OZARKS COMMUNITY HOSPITAL 2828 NORTH NATIONAL SPRINGFIELD MO 65803 GREENE 4178374000 260209 FULTON MEDICAL CENTER LLC 10 SOUTH HOSPITAL DRIVE FULTON MO 65251 CALLAWAY 5736423376 260210 ST ALEXIUS HOSPITAL 3933 S BROADWAY SAINT LOUIS MO 63118 3148657000 260214 BELTON REGIONAL MEDICAL CENTER 17065 S 71 HIGHWAY BELTON MO 64012 CASS 8163481236 260216 SAINT LUKE'S EAST LEE'S SUMMIT HOSPITAL 100 N E SAINT LUKE'S BOULEVARD LEES SUMMIT MO 64086 JACKSON 8163475000 260219 PROGRESS WEST HOSPITAL 2 PROGRESS POINT PKWY O FALLON MO 63368 ST. CHARLES 6363441000 260227 BLACK RIVER COMMUNITY MEDICAL CENTER 217 PHYSICIANS PARK DRIVE POPLAR BLUFF MO 63901 BUTLER 5736866001
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 120 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 260228 MERCY MCCUNE BROOKS HOSPITAL 3125 DR RUSSELL SMITH WAY CARTHAGE MO 64836 JASPER 4173588121 26023F HARRY S TRUMAN MEMORIAL VETERANS HOSPITAL 800 HOSPITAL DRIVE COLUMBIA MO 65201 BOONE 5734432511 261301 ELLETT MEMORIAL HOSPITAL 610 N OHIO AVE APPLETON CITY MO 64724 ST. CLAIR 6604762111 261302 MADISON MEDICAL CENTER 611 W MAIN ST FREDERICKTOWN MO 63645 MADISON 5737813341 261303 COMMUNITY HOSPITAL ASSOCIATION 26136 US HIGHWAY 59, PO BOX 107 FAIRFAX MO 64446 ATCHISON 6606862111 261305 PUTNAM COUNTY MEMORIAL HOSPITAL 1926 OAK STREET, PO BOX 389 UNIONVILLE MO 63565 PUTNAM 6609472411 261306 SULLIVAN COUNTY MEMORIAL HOSPITAL 630 WEST THIRD STREET MILAN MO 63556 SULLIVAN 6602654212 261307 PERSHING MEMORIAL HOSPITAL 130 EAST LOCKLING BROOKFIELD MO 64628 LINN 6602582222 261308 WASHINGTON COUNTY MEMORIAL HOSPITAL 300 HEALTH WAY POTOSI MO 63664 WASHINGTON 5734385451 261309 WRIGHT MEMORIAL HOSPITAL 191 IOWA BOULEVARD TRENTON MO 64683 GRUNDY 6603595621 261310 SCOTLAND COUNTY HOSPITAL 450 E SIGLER AVENUE MEMPHIS MO 63555 SCOTLAND 6604658511 261311 PERRY COUNTY MEMORIAL HOSPITAL 434 NORTH WEST STREET PERRYVILLE MO 63775 PERRY 5735472530 261312 HARRISON COUNTY COMMUNITY HOSPITAL 2600 MILLER STREET BETHANY MO 64424 HARRISON 6604250284 261313 MACON COUNTY SAMARITAN MEMORIAL HOSPITAL 1205 NORTH MISSOURI ST MACON MO 63552 MACON 6603858700 261314 HERMANN AREA DISTRICT HOSPITAL 509 W 18TH ST HERMANN MO 65041 GASCONADE 5734862191 261315 PARKLAND HEALTH CENTER ‐ BONNE TERRE 7245 RAIDER ROAD BONNE TERRE MO 63628 ST. FRANCOIS 5733581400 261316 MERCY HOSPITAL AURORA 500 PORTER AVENUE AURORA MO 65605 LAWRENCE 4176782122 261317 MERCY HOSPITAL CASSVILLE 94 MAIN STREET CASSVILLE MO 65625 BARRY 4178476065 261318 SALEM MEMORIAL DISTRICT HOSPITAL PO BOX 774, SALEM MO 65560 DENT 5737296626 261319 MERCY HOSPITAL LINCOLN 1000 EAST CHERRY STREET TROY MO 63379 LINCOLN 6365288551 261320 LAFAYETTE REGIONAL HEALTH CENTER 1500 STATE STREET LEXINGTON MO 64067 LAFAYETTE 6602592203 261321 HEDRICK MEDICAL CENTER 2799 NORTH WASHINGTON STREET CHILLICOTHE MO 64601 LIVINGSTON 6606461480 261322 EXCELSIOR SPRINGS HOSPITAL 1700 RAINBOW BOULEVARD EXCELSIOR SPRINGS MO 64024 CLAY 8166306081 261323 CEDAR COUNTY MEMORIAL HOSPITAL 1401 SOUTH PARK STREET EL DORADO SPRINGS MO 64744 CEDAR 4178762511 261324 CASS REGIONAL MEDICAL CENTER 2800 E ROCK HAVEN ROAD HARRISONVILLE MO 64701 CASS 8163805888 261325 BARTON COUNTY MEMORIAL HOSPITAL 29 NW 1ST LANE LAMAR MO 64759 BARTON 4176826081 261327 RAY COUNTY MEMORIAL HOSPITAL 904 WOLLARD BOULEVARD RICHMOND MO 64085 RAY 8164705432 261328 NORTHWEST MEDICAL CENTER 705 N COLLEGE STREET ALBANY MO 64402 GENTRY 6607263941 261329 COX MONETT HOSPITAL 801 NORTH LINCOLN AVENUE MONETT MO 65708 BARRY 4173541400 261330 STE GENEVIEVE COUNTY MEMORIAL HOSPITAL 800 STE GENEVIEVE DRIVE, PO BOX 468 SAINTE GENEVIEVE MO 63670 STE. GENEVIEVE 5738832751
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 121 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 261331 FREEMAN NEOSHO HOSPITAL 113 WEST HICKORY STREET NEOSHO MO 64850 NEWTON 4174511234 261332 CARROLL COUNTY MEMORIAL HOSPITAL 1502 NORTH JEFFERSON CARROLLTON MO 64633 CARROLL 6605421695 261333 PIKE COUNTY MEMORIAL HOSPITAL 2305 WEST GEORGIA STREET LOUISIANA MO 63353 PIKE 5737545531 261334 I‐70 COMMUNITY HOSPITAL 105 HOSPITAL DRIVE, BUILDING B SWEET SPRINGS MO 65351 SALINE 6603354700 261335 MERCY ST FRANCIS HOSPITAL 100 WEST HIGHWAY 60, PO BOX 82 MOUNTAIN VIEW MO 65548 HOWELL 4179347000 261336 IRON COUNTY HOSPITAL 301 NORTH HIGHWAY 21 PILOT KNOB MO 63663 IRON 5735461260 261337 MISSOURI BAPTIST SULLIVAN HOSPITAL 751 SAPPINGTON BRIDGE RD SULLIVAN MO 63080 FRANKLIN 5734684186 261338 MERCY HOSPITAL CARTHAGE 3125 DR RUSSELL SMITH WAY CARTHAGE MO 64836 JASPER 4173588121 261339 SOUTHEAST HEALTH CENTER OF REYNOLDS COUNTY 100 HWY 21 N ELLINGTON MO 63638 REYNOLDS 5733344822 261993 PEACE HAVEN ASSOCIATION 12630 ROTT ROAD SAINT LOUIS MO 63127 ST. LOUIS 3149653833 262010 KINDRED HOSPITAL ‐ ST LOUIS 4930 LINDELL BOULEVARD SAINT LOUIS MO 63108 3143618700 262011 KINDRED HOSPITAL ‐ KANSAS CITY 8701 TROOST AVENUE KANSAS CITY MO 64131 JACKSON 8169952000 262013 SELECT SPECIALTY HOSPITAL‐ST LOUIS 300 FIRST CAPITOL DRIVE SAINT CHARLES MO 63301 ST. CHARLES 3147683400 262014 SELECT SPECIALTY HOSPITAL ‐ WESTERN MISSOURI 2316 EAST MEYER BOULEVARD, 3‐WEST KANSAS CITY MO 64132 JACKSON 8162769444 262015 LANDMARK HOSPITAL OF CAPE GIRARDEAU, LLC 3255 INDEPENDENCE CAPE GIRARDEAU MO 63703 CAPE GIRARDEAU 5733351091 262016 LANDMARK HOSPITAL OF JOPLIN, LLC 2040 W 32ND STREET JOPLIN MO 64804 JASPER 4176271309 262017 SELECT SPECIALTY HOSPITAL SPRINGFIELD, INC 1630 EAST PRIMROSE SPRINGFIELD MO 65804 GREENE 4178811657 262018 KINDRED HOSPITAL NORTHLAND 500 NW 68TH STREET KANSAS CITY MO 64118 CLAY 8164206300 262019 MOSIAC LIFE CARE AT ST JOSEPH 5325 FARAON STREET SAINT JOSEPH MO 64506 BUCHANAN 8162716480 262020 LANDMARK HOSPITAL OF COLUMBIA, LLC 604 OLD HIGHWAY 63 NORTH COLUMBIA MO 65201 BOONE 5734996600 262021 KINDRED HOSPITAL‐ST LOUIS AT MERCY 615 S NEW BALLAS ROAD 7TH FLOOR SAINT LOUIS MO 63141 ST. LOUIS 3145674326 263027 RUSK REHABILITATION CTR 315 BUSINESS LOOP 70 W COLUMBIA MO 65203 BOONE 5738172703 263028 THE REHABILITATION INSTITUTE OF ST LOUIS 4455 DUNCAN AVE SAINT LOUIS MO 63110 3146583925 263029 MERCY REHABILITATION HOSPITAL ST LOUIS 14561 NORTH OUTER FORTY CHESTERFIELD MO 63017 ST. LOUIS 3148892704 263030 ST LUKE'S REHABILITATION HOSPITAL 14709 OLIVE BOULEVARD CHESTERFIELD MO 63017 ST. LOUIS 3143175700 263031 SSM REHABILITATION HOSPITAL 1027 BELLEVUE AVENUE RICHMOND HEIGHTS MO 63117 ST. LOUIS 3147685202 263032 MERCY REHABILITATION HOSPITAL SPRINGFIELD 5904 S SOUTHWOOD RD SPRINGFIELD MO 65804 GREENE 4178202973 263301 ST LOUIS CHILDRENS HOSPITAL ONE CHILDRENS PLACE SAINT LOUIS MO 63110 3144546000 263302 CHILDRENS MERCY HOSPITAL 2401 GILLHAM ROAD KANSAS CITY MO 64108 JACKSON 8162343000 263303 RANKEN JORDAN A PEDIATRIC REHAB 11365 DORSETT ROAD MARYLAND HEIGHTS MO 63043 ST. LOUIS 3148726400
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 122 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 263304 SHRINERS HOSPITALS FOR CHILDREN 4400 CLAYTON AVE SAINT LOUIS MO 63110 3144323600 264004 FULTON STATE HOSPITAL 600 EAST 5TH STREET FULTON MO 65251 CALLAWAY 5735924100 264005 SOUTHEAST MISSOURI MENTAL HLTH CTR 1010 WEST COLUMBIA STREET FARMINGTON MO 63640 ST. FRANCOIS 5732186792 264007 NORTHWEST MO PSYCHIATRIC REHAB CTR 3505 FREDERICK AVENUE SAINT JOSEPH MO 64502 BUCHANAN 8163872300 264008 CENTER FOR BEHAVIORAL MEDICINE 1000 E 24TH STREET KANSAS CITY MO 64108 JACKSON 8165127000 264010 ST LOUIS PSYCHIATRIC REHAB CENTER 5400 ARSENAL ST SAINT LOUIS MO 63139 3146448000 264012 CENTERPOINTE HOSPITAL 4801 WELDON SPRING PARKWAY SAINT CHARLES MO 63304 ST. CHARLES 6364417300 264017 TWO RIVERS BEHAVIORAL HEALTH SYSTEM 5121 RAYTOWN ROAD KANSAS CITY MO 64133 JACKSON 8163565688 264018 CRITTENTON CHILDREN'S CENTER 10918 ELM AVENUE KANSAS CITY MO 64134 JACKSON 8167656600 264020 ROYAL OAKS HOSPITAL 307 N MAIN WINDSOR MO 65360 HENRY 6606472182 264024 LAKELAND BEHAVIORAL HEALTH SYSTEM 440 S MARKET SPRINGFIELD MO 65806 GREENE 4178655581 264025 METROPOLITAN ST LOUIS PSYCHIATRIC CTR 5351 DELMAR BOULEVARD SAINT LOUIS MO 63112 3148770500 264028 HAWTHORN CHILDREN'S PSYCHIATRIC HOSPITAL 1901 PENNSYLVANIA AVENUE SAINT LOUIS MO 63133 ST. LOUIS 3145127800 264029 ST LOUIS REGIONAL PSYCHIATRIC STABILIZATION CENTER 5355 DELMAR BLVD SAINT LOUIS MO 63112 3149327110
264030 SIGNATURE PSYCHIATRIC HOSPITAL 2900 CLAY EDWARDS DRIVE NORTH KANSAS CITY MO 64116 CLAY 8166915101 269800 ST LUKE'S HOSPITAL OF KANSAS CITY 4401 WORNALL ROAD KANSAS CITY MO 64111 JACKSON 8169322000 269801 RESEARCH MEDICAL CENTER 2316 EAST MEYER BOULEVARD KANSAS CITY MO 64132 JACKSON 8162764000 269802 ST LOUIS UNIVERSITY HOSPITAL 3635 VISTA AVE, PO BOX 15250 SAINT LOUIS MO 63111 3145778000 269803 BARNES‐JEWISH HOSPITAL 216 SOUTH KINGSHIGHWAY SAINT LOUIS MO 63110 3147473000 269804 UNIVERSITY OF MO HOSPITAL & CLINICS ONE HOSPITAL DRIVE, ROOM CE121, DC031,00 COLUMBIA MO 65212 BOONE 5738824141 269805 ST LOUIS CHILDREN'S HOSPITAL ONE CHILDREN'S PLACE SAINT LOUIS MO 63110 3144546000 269806 THE CHILDREN'S MERCY HOSPITAL 2401 GILLHAM ROAD KANSAS CITY MO 64108 JACKSON 8162343000 269807 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 1465 SOUTH GRAND BOULEVARD SAINT LOUIS MO 63104 3145775600 270003 ST PETER'S HOSPITAL 2475 BROADWAY HELENA MT 59601 LEWIS AND CLARK 4064422480 270004 BILLINGS CLINIC HOSPITAL 2800 10TH AVE N BILLINGS MT 59101 YELLOWSTONE 4066574000 270012 BENEFIS HOSPITALS INC 1101 26TH ST SGREAT FALLS MT 59405 CASCADE 4064555000 270014 ST PATRICK HOSPITAL 500 W BROADWAY MISSOULA MT 59806 MISSOULA 4065437271 270017 ST JAMES HEALTHCARE 400 S CLARK ST BUTTE MT 59701 4067232500 270023 COMMUNITY MEDICAL CENTER 2827 FORT MISSOULA RD MISSOULA MT 59804 MISSOULA 4067284100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 123 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 27002F US AIR FORCE HOSP MALMSTROM AFB GREAT FALLS MT 59402 CASCADE 270032 NORTHERN MONTANA HOSPITAL 30 13TH ST HAVRE MT 59501 HILL 4062652211 27003F VA HOSP FORT HARRISON MT 59636 LEWIS AND CLARK 270049 ST VINCENT HEALTHCARE 1233 N 30TH ST BILLINGS MT 59101 YELLOWSTONE 4066577000 27004F VA HOSP 210 S WINCHESTER AVE MILES CITY MT 59301 CUSTER 270051 KALISPELL REGIONAL MEDICAL CENTER 310 SUNNYVIEW LANE KALISPELL MT 59901 FLATHEAD 4067525111 270057 BOZEMAN HEALTH DEACONESS HOSPITAL 915 HIGHLAND BLVD BOZEMAN MT 59715 GALLATIN 4065855000 270074 P H S INDIAN HOSPITAL AT BROWNING ‐ BLACKFEET 760 HOSPITAL CIRCLE, POST OFFICE BOX 760 BROWNING MT 59417 GLACIER 4063386157 270086 GREAT FALLS CLINIC HOSPITAL 3010 15TH AVENUE SOUTH GREAT FALLS MT 59405 CASCADE 4062168000 270087 THE HEALTHCENTER 320 SUNNYVIEW LANE KALISPELL MT 59901 FLATHEAD 4067564720 271300 POPLAR COMMUNITY HOSPITAL 211 H ST E POPLAR MT 59255 ROOSEVELT 4067686100 271301 FALLON MEDICAL COMPLEX HOSPITAL 202 S 4TH ST W BAKER MT 59313 FALLON 4067783331 271302 DAHL MEMORIAL HEALTHCARE ASSOC 215 SANDY ST EKALAKA MT 59324 CARTER 4067758739 271303 GRANITE COUNTY MEDICAL CENTER 310 SANSOME ST PHILIPSBURG MT 59858 GRANITE 4068593271 271304 MISSOURI RIVER MEDICAL CENTER 1501 ST CHARLES ST FORT BENTON MT 59442 CHOUTEAU 4066223331 271305 MCCONE COUNTY HEALTH CENTER 605 SULLIVAN AVE CIRCLE MT 59215 MCCONE 4064853381 271306 MOUNTAINVIEW MEDICAL CENTER 16 W MAIN ST WHITE SULPHUR SPRING MT 59645 MEAGHER 4065473321 271307 BENEFIS TETON MEDICAL CENTER 915 4TH ST NW CHOTEAU MT 59422 TETON 4064665763 271308 ROOSEVELT MEDICAL CENTER 818 2ND AVE E CULBERTSON MT 59218 ROOSEVELT 4067876401 271309 PRAIRIE COMMUNITY HOSPITAL 312 S ADAMS TERRY MT 59349 PRAIRIE 4066355511 271310 GARFIELD COUNTY HEALTH CENTER 332 LEAVITT AVE JORDAN MT 59337 GARFIELD 4065572500 271311 BIG SANDY MEDICAL CENTER 166 MONTANA AVE EBIG SANDY MT 59520 CHOUTEAU 4063782188 271312 PHILLIPS COUNTY MEDICAL CENTER 311 S 8TH AVE E MALTA MT 59538 PHILLIPS 4066541100 271313 PIONEER MEDICAL CENTER 301 W 7TH AVE BIG TIMBER MT 59011 SWEET GRASS 4069324603 271314 DEER LODGE MEDICAL CENTER 1100 HOLLENBACK LN DEER LODGE MT 59722 POWELL 4068462212 271315 P H S INDIAN HOSPITAL‐FT BELKNAP AT HARLEM ‐ CAH 456 GROS VENTRE AVE, RR 1 HARLEM MT 59526 BLAINE 4063533100
271316 FRANCES MAHON DEACONESS HOSPITAL 621 3RD ST S GLASGOW MT 59230 VALLEY 4062283500 271317 LIVINGSTON HEALTHCARE 504 S 13TH ST LIVINGSTON MT 59047 PARK 4062223541 271318 BARRETT HOSPITAL & HEALTHCARE 600 MT HWY 91 S DILLON MT 59725 BEAVERHEAD 4066833000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 124 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 271319 RUBY VALLEY HOSPITAL 220 E CROFOOT SHERIDAN MT 59749 MADISON 4068425453 271320 CABINET PEAKS MEDICAL CENTER 209 HEALTH PARK DR LIBBY MT 59923 LINCOLN 4062930100 271321 WHEATLAND MEMORIAL HOSPITAL 530 3RD ST NW HARLOWTON MT 59036 WHEATLAND 4066324351 271322 SHERIDAN MEMORIAL HOSPTIAL 440 W LAUREL AVE PLENTYWOOD MT 59254 SHERIDAN 4067653700 271323 CLARK FORK VALLEY HOSPITAL 10 KRUGER RD PLAINS MT 59859 SANDERS 4068264800 271324 PONDERA MEDICAL CENTER 805 SUNSET BLVD CONRAD MT 59425 PONDERA 4062713211 271325 ST LUKE COMMUNITY HOSPITAL 107 6TH AVE SW RONAN MT 59864 LAKE 4066764441 271326 BEARTOOTH BILLINGS CLINIC 2525 N BROADWAY RED LODGE MT 59068 CARBON 4064462345 271327 ROSEBUD HEALTH CARE CENTER 383 N 17TH AV FORSYTH MT 59327 ROSEBUD 4063462161 271328 MARIAS MEDICAL CENTER 640 PARK AVE SHELBY MT 59474 TOOLE 4064343200 271329 MADISON VALLEY MEDICAL CENTER 305 N MAIN ENNIS MT 59729 MADISON 4066824222 271330 STILLWATER BILLINGS CLINIC 710 N 11TH ST COLUMBUS MT 59019 STILLWATER 4063225316 271331 MINERAL COMMUNITY HOSPITAL 1208 6TH AVE E SUPERIOR MT 59872 MINERAL 4068224841 271332 GLENDIVE MEDICAL CENTER 202 PROSPECT DR GLENDIVE MT 59330 DAWSON 4063453306 271333 BROADWATER HEALTH CENTER 110 N OAK ST TOWNSEND MT 59644 BROADWATER 4062663186 271334 LIBERTY MEDICAL CENTER 315 W MADISON AVE CHESTER MT 59522 LIBERTY 4067595181 271335 COMMUNITY HOSPITAL OF ANACONDA 401 W PENNSYLVANIA ANACONDA MT 59711 4065638500 271336 NORTH VALLEY HOSPITAL 1600 HOSPITAL WAY WHITEFISH MT 59937 FLATHEAD 4068633550 271337 NORTHERN ROCKIES MEDICAL CENTER 802 2ND ST SE CUT BANK MT 59427 GLACIER 4068732251 271338 BIG HORN CO MEMORIAL HOSPITAL 17 N MILES HARDIN MT 59034 BIG HORN 4066652310 271339 P H S INDIAN HOSPITAL CROW / NORTHERN CHEYENNE 1010 SOUTH 7650 EAST, POST OFFICE BOX 9CROW AGENCY MT 59022 BIG HORN 4066382626
271340 MARCUS DALY MEMORIAL HOSPITAL ‐ CAH 1200 WESTWOOD DR HAMILTON MT 59840 RAVALLI 4063754408 271341 TRINITY HOSPITAL 315 KNAPP ST WOLF POINT MT 59201 ROOSEVELT 4066536500 271342 DANIELS MEMORIAL HOSPITAL 105 5TH AVE E SCOBEY MT 59263 DANIELS 4064872296 271343 PROVIDENCE ST JOSEPH MEDICAL CENTER 6 13TH AVE E POLSON MT 59860 LAKE 4068835377 271344 SIDNEY HEALTH CENTER 216 14TH AVE SW SIDNEY MT 59270 RICHLAND 4064882100 271345 CENTRAL MONTANA MEDICAL CENTER 408 WENDELL AVE LEWISTOWN MT 59457 FERGUS 4065357711 271346 ROUNDUP MEMORIAL HEALTHCARE 1202 3RD ST W ROUNDUP MT 59072 MUSSELSHELL 4063232301 271347 HOLY ROSARY HEALTHCARE 2600 WILSON ST MILES CITY MT 59301 CUSTER 4062332600
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 125 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 272001 ADVANCED CARE HOSPITAL OF MONTANA 3528 GABEL RD BILLINGS MT 59102 YELLOWSTONE 4063738000 274004 SHODAIR CHILDREN'S HOSPITAL 2755 COLONIAL DR HELENA MT 59601 LEWIS AND CLARK 4064447500 274086 MONTANA STATE HOSPITAL 100 GARNET WAY WARM SPRINGS MT 59756 4066937000 280003 BRYAN MEDICAL CENTER 1600 SOUTH 48TH ST LINCOLN NE 68506 LANCASTER 4024811111 280009 CHI HEALTH GOOD SAMARITAN P O BOX 1990, 10 EAST 31ST ST KEARNEY NE 68848 BUFFALO 3088657100 280013 THE NEBRASKA MEDICAL CENTER DBA NEBRASKA 987400 NEBRASKA MEDICAL CENTER OMAHA NE 68198 DOUGLAS 4025522040 MEDICINE 280020 CHI HEALTH ST ELIZABETH 555 SOUTH 70TH ST LINCOLN NE 68510 LANCASTER 4022197700 280023 CHI HEALTH ST FRANCIS 2620 WEST FAIDLEY AVE GRAND ISLAND NE 68803 HALL 3083844600 280030 CHI HLTH CREIGHTON UNIVERSITY MED CTR‐BERGAN 601 NORTH 30TH ST OMAHA NE 68131 DOUGLAS 4024494000 MERCY 280032 MARY LANNING HEALTHCARE 715 N ST JOSEPH AVE HASTINGS NE 68901 ADAMS 4024634521 280040 METHODIST HOSPITAL 8303 DODGE ST OMAHA NE 68114 DOUGLAS 4023544000 28005F US AIR FORCE HOSP OFFUTT AFB OMAHA NE 68113 SARPY 4022947312 280060 CHI HLTH CREIGHTON UNIVERSITY MED CTR‐BERGAN 7500 MERCY RD OMAHA NE 68124 DOUGLAS 4023986060 MERCY 280061 REGIONAL WEST MEDICAL CENTER 4021 AVE B SCOTTSBLUFF NE 69361 SCOTTS BLUFF 3086353711 280065 GREAT PLAINS HEALTH 601 WEST LEOTA ST NORTH PLATTE NE 69101 LINCOLN 3086968000 28006F VA HOSPITAL 4101 WOOLWORTH AVE OMAHA NE 68105 DOUGLAS 4024490600 280077 FREMONT HEALTH MEDICAL CENTER 450 EAST 23RD ST FREMONT NE 68025 DODGE 4027211610 280081 CHI HEALTH IMMANUEL 6901 NORTH 72ND ST OMAHA NE 68122 DOUGLAS 4025722121 280105 CHI HEALTH MIDLANDS 11111 SOUTH 84TH ST PAPILLION NE 68046 SARPY 4025933000 280111 COLUMBUS COMMUNITY HOSPITAL 4600 38TH ST COLUMBUS NE 68601 PLATTE 4025647118 280125 FAITH REGIONAL HEALTH SERVICES 2700 WEST NORFOLK AVE NORFOLK NE 68701 MADISON 4023714880 280127 LINCOLN SURGICAL HOSPITAL 1710 SOUTH 70TH ST, SUITE 200 LINCOLN NE 68506 LANCASTER 4024849090 280128 CHI HEALTH NEBRASKA HEART 7500 SOUTH 91ST ST LINCOLN NE 68526 LANCASTER 4023283000 280129 NEBRASKA ORTHOPAEDIC HOSPITAL 2808 SOUTH 143RD PLZ OMAHA NE 68144 DOUGLAS 4026091600 280130 CHI HEALTH LAKESIDE 16901 LAKESIDE HILLS CT OMAHA NE 68130 DOUGLAS 4027178000 280131 MIDWEST SURGICAL HOSPITAL LLC 7915 FARNAM DRIVE OMAHA NE 68114 DOUGLAS 4023991900 280132 BELLEVUE MEDICAL CENTER DBA NEBRASKA MEDICINE‐ 2500 BELLEVUE MEDICAL CENTER DR BELLEVUE NE 68123 SARPY 4027633600 BELL 280133 NEBRASKA SPINE HOSPITAL, LLC P O BOX 34400, 6901 NORTH 72ND ST, STE 20300 OMAHA NE 68122 DOUGLAS 4025723000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 126 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 280134 KEARNEY REGIONAL MEDICAL CENTER 804 22ND AVENUE KEARNEY NE 68845 BUFFALO 3084553600 281300 HARLAN COUNTY HEALTH SYSTEM P O BOX 836, 717 NORTH BROWN ST ALMA NE 68920 HARLAN 3089282151 281301 FILLMORE COUNTY HOSPITAL P O BOX 193, 1900 F STREET GENEVA NE 68361 FILLMORE 4027593167 281302 PAWNEE COUNTY MEMORIAL HOSPITAL P O BOX 433, 600 I ST PAWNEE CITY NE 68420 PAWNEE 4028522231 281303 NIOBRARA VALLEY HOSPITAL P O BOX 118, 401 SOUTH 5TH STREET LYNCH NE 68746 BOYD 4025692451 281304 THAYER COUNTY HEALTH SERVICES 120 PARK AVE HEBRON NE 68370 THAYER 4027686041 281305 KIMBALL HEALTH SERVICES 505 SOUTH BURG ST KIMBALL NE 69145 KIMBALL 3082351952 281306 KEARNEY COUNTY HEALTH SERVICES HOSPITAL 727 EAST 1ST ST MINDEN NE 68959 KEARNEY 3088323400 281307 SAUNDERS MEDICAL CENTER 1760 COUNTY RD J WAHOO NE 68066 SAUNDERS 4024434191 281308 HENDERSON HEALTH CARE SERVICES 1621 FRONT STREET HENDERSON NE 68371 YORK 4027234512 281309 COMMUNITY MEMORIAL HOSPITAL P O BOX N, 1579 MIDLAND ST SYRACUSE NE 68446 OTOE 4022692011 281310 REGIONAL WEST GARDEN COUNTY HOSPITAL 1100 WEST 2ND ST OSHKOSH NE 69154 GARDEN 3087723283 281311 FRANKLIN COUNTY MEMORIAL HOSPITAL 1406 Q ST FRANKLIN NE 68939 FRANKLIN 3084256221 281312 GENOA COMMUNITY HOSPITAL P O BOX 310, 606/706 EWING AVE GENOA NE 68640 NANCE 4029932283 281313 GOTHENBURG MEMORIAL HOSPITAL 910 20TH ST GOTHENBURG NE 69138 DAWSON 3085373661 281314 ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER P O BOX 428, 531 BEEBE ST OSCEOLA NE 68651 POLK 4027472031 281315 BRODSTONE MEMORIAL HOSP P O BOX 187, 520 EAST 10TH ST SUPERIOR NE 68978 NUCKOLLS 4028793281 281316 WEBSTER COUNTY COMMUNITY HOSPITAL P O BOX 465, 621 N FRANKLIN ST RED CLOUD NE 68970 WEBSTER 4027465600 281318 MORRILL COUNTY COMMUNITY HOSPITAL 1313 S STREET BRIDGEPORT NE 69336 MORRILL 3082621616 281319 JEFFERSON COMMUNITY HEALTH CENTER P O BOX 277, 2200 H ST FAIRBURY NE 68352 JEFFERSON 4027293351 281320 MEMORIAL HOSPITAL 1423 SEVENTH ST AURORA NE 68818 HAMILTON 4026943171 281321 OAKLAND MERCY HOSPITAL 601 EAST SECOND ST OAKLAND NE 68045 BURT 4026855601 281322 ST FRANCIS MEMORIAL HOSPITAL 430 NORTH MONITOR ST WEST POINT NE 68788 CUMING 4023722404 281323 CHI HEALTH SCHUYLER 104 WEST 17TH ST SCHUYLER NE 68661 COLFAX 4023522441 281324 NEMAHA COUNTY HOSPITAL 2022 13TH ST AUBURN NE 68305 NEMAHA 4022744366 281325 BROWN COUNTY HOSPITAL 945 EAST ZERO ST AINSWORTH NE 69210 BROWN 4023872800 281326 ANTELOPE MEMORIAL HOSPITAL P O BOX 229, 102 WEST 9TH ST NELIGH NE 68756 ANTELOPE 4028874151 281327 COZAD COMMUNITY HOSPITAL P O BOX 108, 300 EAST 12TH ST COZAD NE 69130 DAWSON 3087842261 281328 LITZENBERG MEMORIAL COUNTY HOSPITAL 1715 26TH ST CENTRAL CITY NE 68826 MERRICK 3089463015 281329 AVERA ST ANTHONY'S HOSPITAL 300 NORTH 2ND ST O' NEILL NE 68763 HOLT 4023362611
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 127 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 281330 WARREN MEMORIAL HOSPITAL 905 SECOND ST FRIEND NE 68359 SALINE 4029472541 281331 AVERA CREIGHTON HOSPITAL P O BOX 186, 1503 MAIN ST CREIGHTON NE 68729 KNOX 4023585700 281332 BUTLER COUNTY HEALTH CARE CENTER 372 SOUTH 9TH ST DAVID CITY NE 68632 BUTLER 4023671200 281333 ROCK COUNTY HOSPITAL 102 EAST SOUTH STREET BASSETT NE 68714 ROCK 4026843366 281334 BOONE COUNTY HEALTH CENTER P O BOX 151, 723 WEST FAIRVIEW ST ALBION NE 68620 BOONE 4023952191 281335 CALLAWAY DISTRICT HOSPITAL P O BOX 100, 211 E KIMBALL ST CALLAWAY NE 68825 CUSTER 3088362228 281336 YORK GENERAL HOSPITAL 2222 LINCOLN AVE YORK NE 68467 YORK 4023626671 281338 HOWARD COUNTY MEDICAL CENTER P O BOX 406, 1113 SHERMAN ST ST PAUL NE 68873 HOWARD 3087544421 281339 MEMORIAL HEALTH CARE SYSTEMS 300 NORTH COLUMBIA AVE SEWARD NE 68434 SEWARD 4026432971 281340 DUNDY COUNTY HOSPITAL P O BOX 626, 1313 NORTH CHEYENNE ST BENKELMAN NE 69021 DUNDY 3084232204 281341 CHADRON COMMUNITY HOSPITAL AND HEALTH SERVICES 825 CENTENNIAL DRIVE CHADRON NE 69337 DAWES 3084325586
281342 CHI HEALTH ST MARY'S 1301 GRUNDMAN BLVD NEBRASKA CITY NE 68410 OTOE 4028733321 281343 WEST HOLT MEMORIAL HOSPITAL 406 W NEELY ST ATKINSON NE 68713 HOLT 4029252811 281344 CHERRY COUNTY HOSPITAL P O BOX 410, 510 NORTH GREEN ST VALENTINE NE 69201 CHERRY 4023762525 281345 PROVIDENCE MEDICAL CENTER 1200 PROVIDENCE RD WAYNE NE 68787 WAYNE 4023753800 281346 CHI HEALTH PLAINVIEW P O BOX 489, 704 NORTH THIRD ST PLAINVIEW NE 68769 PIERCE 4025824245 281347 OSMOND GENERAL HOSPITAL P O BOX 429, 402 NORTH MAPLE ST OSMOND NE 68765 PIERCE 4027483393 281348 TRI VALLEY HEALTH SYSTEM 1305 WEST HIGHWAY 6/34 CAMBRIDGE NE 69022 FURNAS 3086973329 281349 PENDER COMMUNITY HOSPITAL P O BOX 100, 100 HOSPITAL DRIVE PENDER NE 68047 THURSTON 4023853083 281350 JOHNSON COUNTY HOSPITAL 202 HIGH ST TECUMSEH NE 68450 JOHNSON 4023353361 281351 CHASE COUNTY COMMUNITY HOSPITAL P O BOX 819, 600 W 12TH ST IMPERIAL NE 69033 CHASE 3088827111 281352 COMMUNITY MEDICAL CENTER, INC P O BOX 399, 3307 BARADA ST FALLS CITY NE 68355 RICHARDSON 4022452428 281353 VALLEY COUNTY HEALTH SYSTEM 2707 L STREET ORD NE 68862 VALLEY 3087284200 281354 CRETE AREA MEDICAL CENTER P O BOX 220, 2910 BETTEN DR CRETE NE 68333 SALINE 4028262102 281355 OGALLALA COMMUNITY HOSPITAL 2601 NORTH SPRUCE ST OGALLALA NE 69153 KEITH 3082844011 281356 PERKINS COUNTY HEALTH SERVICES 900 LINCOLN AVE GRANT NE 69140 PERKINS 3083527200 281357 SIDNEY REGIONAL MEDICAL CENTER 1000 POLE CREEK CROSSING SIDNEY NE 69162 CHEYENNE 3082545825 281358 GORDON MEMORIAL HOSPITAL DISTRICT 300 EAST 8TH ST GORDON NE 69343 SHERIDAN 3082820401 281359 MEMORIAL COMMUNITY HOSPITAL MCH & HEALTH 810 NORTH 22ND ST BLAIR NE 68008 WASHINGTON 4024262182 SYSTEM
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 128 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 281360 BOX BUTTE GENERAL HOSPITAL P O BOX 810, 2101 BOX BUTTE AVE ALLIANCE NE 69301 BOX BUTTE 3087626660 281361 LEXINGTON REGIONAL HEALTH CENTER P O BOX 980, 1201 NORTH ERIE ST LEXINGTON NE 68850 DAWSON 3083245651 281362 PHELPS MEMORIAL HEALTH CENTER 1215 TIBBALS ST HOLDREGE NE 68949 PHELPS 3089952211 281363 COMMUNITY HOSPITAL P O BOX 1328, 1301 EAST H ST MCCOOK NE 69001 RED WILLOW 3083442650 281364 BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC P O BOX 278, 4800 HOSPITAL PARKWAY BEATRICE NE 68310 GAGE 4022283344
281365 JENNIE M MELHAM MEMORIAL MEDICAL CENTER 145 MEMORIAL DRIVE BROKEN BOW NE 68822 CUSTER 3088724100 282000 MADONNA REHABILITATION LTC HOSPITAL 5401 SOUTH ST LINCOLN NE 68506 LANCASTER 4024133000 282001 SELECT SPECIALTY HOSPITAL ‐ OMAHA (CENTRAL CAMPUS) 1870 SOUTH 75TH STREET OMAHA NE 68124 DOUGLAS 4023615755
282002 SELECT SPECIALTY HOSPITAL ‐ LINCOLN 2300 SOUTH 16TH STREET ‐ 7TH FLOOR LINCOLN NE 68502 LANCASTER 4023615755 282003 MADONNA REHABILITATION SPECIALTY HOSPITAL 2500 BELLEVUE MEDICAL CENTER DRIVE, 4TH FLOOR BELLEVUE NE 68123 SARPY 4028840006 283025 MADONNA REHABILITATION HOSPITAL 5401 SOUTH ST LINCOLN NE 68506 LANCASTER 4024133000 283300 BOYS TOWN NATIONAL RESEARCH HOSPITAL 555 NORTH 30TH ST OMAHA NE 68131 DOUGLAS 4024986362 283301 CHILDREN'S HOSPITAL & MEDICAL CENTER 8200 DODGE ST OMAHA NE 68114 DOUGLAS 4029555400 284003 LINCOLN REGIONAL CENTER PO BOX 94949 FOLSOM & WEST PROSPECTOR LINCOLN NE 68509 LANCASTER 4024714444 284009 DOUGLAS COUNTY HEALTH CENTER 4102 WOOLWORTH AVE OMAHA NE 68105 DOUGLAS 4024447676 289805 THE NEBRASKA MEDICAL CENTER 987435 NEBRASKA MEDICAL CENTER OMAHA NE 68198 DOUGLAS 4025595443 289806 CHILDREN'S HOSPITAL & MEDICAL CENTER TRANSPLANT 8200 DODGE STREET OMAHA NE 68114 DOUGLAS 4029554374
290001 RENOWN REGIONAL MEDICAL CENTER 1155 MILL STREET RENO NV 89502 WASHOE 7759824100 290003 SUNRISE HOSPITAL AND MEDICAL CENTER 3186 S MARYLAND PKWY LAS VEGAS NV 89109 CLARK 7027318000 290005 NORTH VISTA HOSPITAL 1409 EAST LAKE MEAD BLVD NORTH LAS VEGAS NV 89030 CLARK 7026575504 290006 BANNER CHURCHILL COMMUNITY HOSPITAL 801 EAST WILLIAMS AVENUE FALLON NV 89406 CHURCHILL 7754233151 290007 UNIVERSITY MEDICAL CENTER 1800 W CHARLESTON BLVD LAS VEGAS NV 89102 CLARK 7023832000 290008 NORTHEASTERN NEVADA REGIONAL HOSPITAL 2001 ERRECART BLVD ELKO NV 89801 ELKO 7757385151 290009 SAINT MARY'S REGIONAL MEDICAL CENTER 235 W 6TH ST RENO NV 89503 WASHOE 7757703000 290012 ST ROSE DOMINICAN HOSPITALS ‐ ROSE DE LIMA CAMPUS 102 E LAKE MEAD DR HENDERSON NV 89015 CLARK 7026165000
290019 CARSON TAHOE REGIONAL MEDICAL CENTER 1600 MEDICAL PARKWAY CARSON CITY NV 89703 7754458000 29001E ST ROSE DOMINICAN HOSPITAL SIENA CAMPUS 3001 ST ROSE PARKWAY HENDERSON NV 89052 WASHOE 29001F US AIR FORCE HOSP NELLIS AFB LAS VEGAS NV 89110 CLARK
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 129 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 290021 VALLEY HOSPITAL MEDICAL CENTER 620 SHADOW LANE LAS VEGAS NV 89106 CLARK 7023884000 290022 DESERT SPRINGS HOSPITAL 2075 EAST FLAMINGO ROAD LAS VEGAS NV 89119 CLARK 7023697600 29002E SPRING VALLEY HOSPITAL 5400 SOUTH RAINBOW BLVD LAS VEGAS NV 89118 CLARK 7028533000 29002F VA HOSP 1000 LOCUST ST RENO NV 89502 WASHOE 7757867200 290032 NORTHERN NEVADA MEDICAL CENTER 2375 PRATER WAY SPARKS NV 89434 WASHOE 7753317000 290039 MOUNTAINVIEW HOSPITAL 3100 N TENAYA WAY LAS VEGAS NV 89128 CLARK 7022555065 29003E MESA VIEW REGIONAL HOSPITAL 1299 BERTHA HOWE AVENUE, PO BOX 3540 MESQUITE NV 89024 CLARK 7023468040 29003F PUBLIC HEALTH SERV INDIAN HOSP OWYHEE NV 89832 ELKO 290041 SUMMERLIN HOSPITAL MEDICAL CENTER 657 TOWN CENTER DRIVE LAS VEGAS NV 89144 CLARK 7022337500 290042 HARMON HOSPITAL 2170 EAST HARMON AVENUE LAS VEGAS NV 89119 CLARK 7027940100 290045 ST ROSE DOMINICAN HOSPITALS ‐ SIENA CAMPUS 3001 ST ROSE PARKWAY HENDERSON NV 89052 CLARK 7026165000 290046 SPRING VALLEY HOSPITAL MEDICAL CENTER 5400 SOUTH RAINBOW BLVD LAS VEGAS NV 89118 CLARK 7028533000 290047 SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER 9300 WEST SUNSET RD LAS VEGAS NV 89148 CLARK 7028802100 290049 RENOWN SOUTH MEADOWS MEDICAL CENTER 10101 DOUBLE R BLVD RENO NV 89521 7759827063 29004F VA SOUTHERN NEVADA HEALTHCARE SYSTEM 1700 VEGAS DRIVE LAS VEGAS NV 89106 CLARK 7026363000 290051 SIERRA SURGERY HOSPITAL 1400 MEDICAL PKWY CARSON CITY NV 89703 7758831700 290053 ST ROSE DOMINICAN HOSPITALS ‐ SAN MARTIN CAMPUS 8280 W WARM SPRINGS ROAD LAS VEGAS NV 89113 CLARK 7024928509
290054 CENTENNIAL HILLS HOSPITAL MEDICAL CENTER 6900 N DURANGO DR LAS VEGAS NV 89149 CLARK 7028359700 290056 MOUNTAIN'S EDGE HOSPITAL 8656 WEST PATRICK LANE LAS VEGAS NV 89148 CLARK 7025920281 291300 MOUNT GRANT GENERAL HOSPITAL FIRST AND A STREETS HAWTHORNE NV 89415 MINERAL 7029452461 291301 INCLINE VILLAGE HEALTH CENTER 880 ALDER STREET INCLINE VILLAGE NV 89451 WASHOE 7758334100 291302 WILLIAM BEE RIRIE HOSPITAL 1500 AVENUE H ELY NV 89301 WHITE PINE 7752893001 291303 BATTLE MOUNTAIN GENERAL HOSPITAL 535 SOUTH HUMBOLDT STREET BATTE MTN NV 89820 LANDER 7756352550 291304 PERSHING GENERAL HOSPITAL 855 6TH STREET/PO BOX 661 LOVELOCK NV 89419 PERSHING 7752732621 291306 CARSON VALLEY MEDICAL CENTER 1107 HIGHWAY 395 GARDNERVILLE NV 89410 DOUGLAS 7757821500 291307 MESA VIEW REGIONAL HOSPITAL 1299 BERTHA HOWE AVENUE MESQUITE NV 89027 CLARK 7023468040 291308 HUMBOLDT GENERAL HOSPITAL 118 EAST HASKELL STREET WINNEMUCCA NV 89445 HUMBOLDT 7756235222 291309 BOULDER CITY HOSPITAL 901 ADAMS BLVD BOULDER CITY NV 89005 CLARK 7022934111 291311 DESERT VIEW REGIONAL MEDICAL CENTER 360 SOUTH LOLA LANE PAHRUMP NV 89048 NYE 7757517500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 130 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 291312 GROVER C DILS MEDICAL CENTER 700 N SPRING ST, BOX 1010‐C‐ADM BLDG CALIENTE NV 89008 LINCOLN 7757263171 292002 KINDRED HOSPITAL ‐ LAS VEGAS (SAHARA CAMPUS) 5110 W SAHARA AVE LAS VEGAS NV 89146 CLARK 7028352926 292003 HORIZON SPECIALTY HOSPITAL 640 DESERT LANE LAS VEGAS NV 89106 CLARK 7023823155 292004 TAHOE PACIFIC HOSPITAL ‐ MEADOWS 10101 DOUBLE R BLVD‐1ST FLOOR RENO NV 89521 WASHOE 7753311044 292006 COMPLEX CARE HOSPITAL AT TENAYA 2500 TENAYA WAY LAS VEGAS NV 89128 CLARK 7025622021 292007 LAS VEGAS‐AMG SPECIALTY HOSPITAL 4015 SOUTH MCLEOD LAS VEGAS NV 89121 CLARK 7024332200 292008 CARSON TAHOE CONTINUING CARE HOSPITAL 775 FLEISCHMANN WAY 2ND FLR CARSON CITY NV 89703 7754457783 293026 HEALTHSOUTH REHABILITATION HOSPITAL OF LAS VEGAS 1250 S VALLEY VIEW BLVD LAS VEGAS NV 89102 CLARK 7028778898
293032 HEALTHSOUTH REHABILITIATION HOSPITAL OF HENDERSON 10301 JEFFREYS ST HENDERSON NV 89052 CLARK 7029399400
293033 HEALTHSOUTH DESERT CANYON REHABILITATION 9175 WEST OQUENDO ROAD LAS VEGAS NV 89148 CLARK 7022527342 HOSPITAL 294000 DINI‐TOWNSEND HOSPITAL AT NNMH 480 GALLETTI WAY SPARKS NV 89431 WASHOE 7756882001 294002 SOUTHERN NEVADA ADULT MENTAL HEALTH SERVICES 6161 W CHARLESTON BLVD LAS VEGAS NV 89146 CLARK 7024866000
294003 BHC WEST HILLS HOSPITAL 1240 E NINTH ST RENO NV 89512 WASHOE 7753230478 294008 RED ROCK BEHAVIORAL HEALTH HOSPITAL 5975 WEST TWAIN AVENUE LAS VEGAS NV 89103 CLARK 7022148099 294009 MONTEVISTA HOSPITAL 5900 WEST ROCHELLE AVENUE LAS VEGAS NV 89103 CLARK 7023641111 294010 SPRING MOUNTAIN SAHARA 5460 WEST SAHARA LAS VEGAS NV 89146 CLARK 7028732400 294011 SPRING MOUNTAIN TREATMENT CENTER 7000 WEST SPRING MOUNTAIN ROAD LAS VEGAS NV 89117 CLARK 7028732400 294012 SEVEN HILLS BEHAVIORAL INSTITUTE 3021 W HORIZON RIDGE PKWY HENDERSON NV 89052 CLARK 7026465000 299800 UMC TRANSPLANTATION SERVICES 1800 W CHARLESTON BLVD LAS VEGAS NV 89102 CLARK 7023833658 300001 CONCORD HOSPITAL 250 PLEASANT ST CONCORD NH 03301 MERRIMACK 6032252711 300003 MARY HITCHCOCK MEMORIAL HOSPITAL 1 MEDICAL CENTER DRIVE LEBANON NH 03756 GRAFTON 6036505000 300005 LAKES REGION GENERAL HOSPITAL 80 HIGHLAND ST LACONIA NH 03246 BELKNAP 6035243211 300011 ST JOSEPH HOSPITAL 172 KINSLEY ST NASHUA NH 03060 HILLSBOROUGH 6038823000 300012 ELLIOT HOSPITAL 1 ELLIOT WAY MANCHESTER NH 03103 HILLSBOROUGH 6036695300 300014 FRISBIE MEMORIAL HOSPITAL 11 WHITEHALL ROAD ROCHESTER NH 03867 STRAFFORD 6033325211 300017 PARKLAND MEDICAL CENTER 1 PARKLAND DRIVE DERRY NH 03038 ROCKINGHAM 6034212100 300018 WENTWORTH‐DOUGLASS HOSPITAL 789 CENTRAL AVE DOVER NH 03820 STRAFFORD 6037402580 300019 CHESHIRE MEDICAL CENTER 580 COURT STREET KEENE NH 03431 CHESHIRE 6033545400
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 131 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 30001F VA HOSP 718 SMYTH RD MANCHESTER NH 03104 HILLSBOROUGH 300020 SOUTHERN NH MEDICAL CENTER 8 PROSPECT STREET NASHUA NH 03060 HILLSBOROUGH 6035772000 300023 EXETER HOSPITAL INC 5 ALUMNI DRIVE EXETER NH 03833 ROCKINGHAM 6037787311 300029 PORTSMOUTH REGIONAL HOSPITAL 333 BORTHWICK AVE PORTSMOUTH NH 03801 ROCKINGHAM 6034365110 30002F US NAVAL HOSP PORTSMOUTH NH 03801 ROCKINGHAM 6039999999 300034 CATHOLIC MEDICAL CENTER 100 MCGREGOR STREET MANCHESTER NH 03102 HILLSBOROUGH 6036683545 30004E MORRISON HOSP 2‐6 TERRACE ST WHITEFIELD NH 03598 COOS 6039999999 30005E MOORE GEN HOSP ROUTE 2 GOFFSTOWN NH 03045 HILLSBOROUGH 6039999999 301300 UPPER CONNECTICUT VALLEY HOSPITAL 181 CORLISS LANE COLEBROOK NH 03576 COOS 6032374971 301301 COTTAGE HOSPITAL 90 SWIFTWATER RD WOODSVILLE NH 03785 GRAFTON 6037479000 301302 LITTLETON REGIONAL HEALTHCARE 600 ST JOHNSBURY ROAD LITTLETON NH 03561 GRAFTON 6034449000 301303 WEEKS MEDICAL CENTER 173 MIDDLE STREET LANCASTER NH 03584 COOS 6037884911 301304 NEW LONDON HOSPITAL 273 COUNTY ROAD NEW LONDON NH 03257 MERRIMACK 6035262911 301305 ALICE PECK DAY MEMORIAL HOSPITAL 10 ALICE PECK DAY DRIVE LEBANON NH 03766 GRAFTON 6034483121 301306 FRANKLIN REGIONAL HOSPITAL 15 AIKEN AVENUE FRANKLIN NH 03235 MERRIMACK 6039342060 301307 MEMORIAL HOSPITAL, THE 3073 WHITE MOUNTAIN HIGHWAY NORTH CONWAY NH 03860 CARROLL 6033565461 301308 VALLEY REGIONAL HOSPITAL 243 ELM STREET CLAREMONT NH 03743 SULLIVAN 6035427771 301309 MONADNOCK COMMUNITY HOSPITAL 452 OLD STREET ROAD PETERBOROUGH NH 03458 HILLSBOROUGH 6039247191 301310 ANDROSCOGGIN VALLEY HOSPITAL 59 PAGE HILL ROAD BERLIN NH 03570 COOS 6037522200 301311 SPEARE MEMORIAL HOSPITAL 16 HOSPITAL ROAD PLYMOUTH NH 03264 GRAFTON 6035361120 301312 HUGGINS HOSPITAL 240 SOUTH MAIN STREET WOLFEBORO NH 03894 CARROLL 6035697500 303026 NORTHEAST REHABILITATION HOSPITAL 70 BUTLER STREET SALEM NH 03079 ROCKINGHAM 6038932900 303027 HEALTHSOUTH REHABILITATION HOSPITAL 254 PLEASANT STREET CONCORD NH 03301 MERRIMACK 6032269800 304000 NEW HAMPSHIRE HOSP‐PSYCH UNIT 36 CLINTON STREET CONCORD NH 03301 MERRIMACK 6032715300 304001 HAMPSTEAD HOSPITAL 218 EAST ROAD HAMPSTEAD NH 03841 ROCKINGHAM 6033295311 309801 MARY HITCHCOCK MEMORIAL HOSPITAL ‐ TRANSPLANT ONE MEDICAL CENTER DRIVE LEBANON NH 03756 GRAFTON 6036533770
310001 HACKENSACK UNIVERSITY MEDICAL CENTER 30 PROSPECT AVE HACKENSACK NJ 07601 BERGEN 2019962000 310002 NEWARK BETH ISRAEL MEDICAL CENTER 201 LYONS AVE NEWARK NJ 07112 ESSEX 9739267850 310003 PALISADES MEDICAL CENTER 7600 RIVER RD NORTH BERGEN NJ 07047 HUDSON 2018545000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 132 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 310005 HUNTERDON MEDICAL CENTER 2100 WESCOTT DRIVE FLEMINGTON NJ 08822 HUNTERDON 9087886100 310006 ST MARY'S GENERAL HOSPITAL 350 BOULEVARD PASSAIC NJ 07055 PASSAIC 9733654300 310008 HOLY NAME MEDICAL CENTER 718 TEANECK RD TEANECK NJ 07666 BERGEN 2018333000 310009 CLARA MAASS MEDICAL CENTER ONE CLARA MAAS DRIVE BELLEVILLE NJ 07109 ESSEX 9734502002 310010 UNIV MEDICAL CENTER OF PRINCETON AT PLAINSBORO ONE‐FIVE PLAINSBORO ROAD PLAINSBORO NJ 08536 MIDDLESEX 8664604776
310011 CAPE REGIONAL MEDICAL CENTER INC TWO STONE HARBOR BLVD CAPE MAY COURT HOUSE NJ 08210 CAPE MAY 6094632000 310012 VALLEY HOSPITAL 223 N VAN DIEN AVENUE RIDGEWOOD NJ 07450 BERGEN 2014478000 310014 COOPER UNIVERSITY HOSPITAL 1 COOPER PLAZA CAMDEN NJ 08103 CAMDEN 8563422000 310015 MORRISTOWN MEDICAL CENTER 100 MADISON AVE MORRISTOWN NJ 07962 MORRIS 9739715450 310016 CAREPOINT HEALTH‐CHRIST HOSPITAL 176 PALISADE AVE JERSEY CITY NJ 07306 HUDSON 2017958200 310017 CHILTON MEDICAL CENTER 97 WEST PARKWAY POMPTON PLAINS NJ 07444 MORRIS 9738315000 310019 ST JOSEPH'S REGIONAL MEDICAL CENTER 703 MAIN ST PATERSON NJ 07503 PASSAIC 9737542010 31001F VA HOSP TREMONT AVE + S CENTRE ST EAST ORANGE NJ 07019 ESSEX 310021 ST FRANCIS MEDICAL CENTER 601 HAMILTON AVE TRENTON NJ 08629 MERCER 6095995000 310022 VIRTUA WEST JERSEY HOSPITALS BERLIN WHITEHORSE PIKE AND TOWNSEND AVENUE BERLIN NJ 08009 CAMDEN 8563223200 310024 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT 865 STONE ST RAHWAY NJ 07065 UNION 7323814200 RAHWAY 310025 CAREPOINT HEALTH ‐ BAYONNE MEDICAL CENTER 29 EAST 29TH ST BAYONNE NJ 07002 HUDSON 2018585000 310027 TRINITAS REGIONAL MEDICAL CENTER 225 WILLIAMSON STREET ELIZABETH NJ 07207 UNION 9089945000 310028 NEWTON MEDICAL CENTER 175 HIGH ST NEWTON NJ 07860 SUSSEX 9735798300 310029 OUR LADY OF LOURDES MEDICAL CENTER 1600 HADDON AVENUE CAMDEN NJ 08103 CAMDEN 8567573500 310031 DEBORAH HEART AND LUNG CENTER 200 TRENTON ROAD BROWNS MILLS NJ 08015 BURLINGTON 6098936611 310032 INSPIRA MEDICAL CENTER VINELAND 1505 W SHERMAN AVE VINELAND NJ 08360 CUMBERLAND 8566416610 310034 RIVERVIEW MEDICAL CENTER ONE RIVERVIEW PLAZA RED BANK NJ 07701 MONMOUTH 7327412700 310038 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK NJ 08901 MIDDLESEX 7329378900 310039 RARITAN BAY MEDICAL CENTER PERTH AMBOY DIVISION 530 NEW BRUNSWICK AVE PERTH AMBOY NJ 08861 MIDDLESEX 7324423700
31003F US ARMY HOSP FORT MONMOUTH NJ 07703 MONMOUTH 310040 CAREPOINT HEALTH‐HOBOKEN UNIVERSITY MEDICAL 308 WILLOW AVE HOBOKEN NJ 07030 HUDSON 2014181000 CENTER 310041 COMMUNITY MEDICAL CENTER 99 RT 37 WEST TOMS RIVER NJ 08755 OCEAN 7325578000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 133 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 310042 CLARA MAASS MEDICAL CENTER, WEST HUDSON DIVISION 206 BERGEN AVE KEARNY NJ 07032 HUDSON 2019557000
310044 CAPITAL HEALTH MEDICAL CENTER ‐ HOPEWELL ONE CAPITAL WAY PENNINGTON NJ 08534 MERCER 6093034000 310045 ENGLEWOOD HOSPITAL AND MEDICAL CENTER 350 ENGLE ST ENGLEWOOD NJ 07631 BERGEN 2018943000 310047 SHORE MEDICAL CENTER 100 MEDICAL CENTER WAY SOMERS POINT NJ 08244 ATLANTIC 6096533545 310048 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL 110 REHILL AVE SOMERVILLE NJ 08876 SOMERSET 9086852200 SOMERSET 31004F VA HOSP LYONS NJ 07939 SOMERSET 310050 SAINT CLARE'S HOSPITAL 25 POCONO ROAD DENVILLE NJ 07834 MORRIS 9739835506 310051 OVERLOOK MEDICAL CENTER 99 BEAUVOIR AVENUE SUMMIT NJ 07902 UNION 9085222000 310052 OCEAN MEDICAL CENTER 425 JACK MARTIN BLVD BRICK NJ 08724 OCEAN 7328402200 310054 HACKENSACK‐UMC MOUNTAINSIDE BAY AND HIGHLAND AVE MONTCLAIR NJ 07042 ESSEX 9734296000 310057 VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY 175 MADISON AVE MOUNT HOLLY NJ 08060 BURLINGTON 6099146200
310058 BERGEN REGIONAL MEDICAL CENTER 230 EAST RIDGEWOOD AVE PARAMUS NJ 07652 BERGEN 2019674000 310060 ST LUKE'S WARREN HOSPITAL 185 ROSEBERRY ST PHILLIPSBURG NJ 08865 WARREN 9088476700 310061 LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 218A SUNSET ROAD WILLINGBORO NJ 08046 BURLINGTON 6098352900
310064 ATLANTICARE REGIONAL MEDICAL CENTER ‐ CITY CAMPUS 1925 PACIFIC AVENUE ATLANTIC CITY NJ 08401 ATLANTIC 6094418020
310069 INSPIRA MEDICAL CENTER ELMER 501 WEST FRONT STREET, POST OFFICE BOX 1090 ELMER NJ 08318 SALEM 8563631000 310070 SAINT PETER'S UNIVERSITY HOSPITAL 254 EASTON AVE NEW BRUNSWICK NJ 08901 MIDDLESEX 7327458600 310073 JERSEY SHORE UNIVERSITY MEDICAL CENTER 1945 RTE 33 NEPTUNE NJ 07754 MONMOUTH 7327755500 310074 JERSEY CITY MEDICAL CENTER 355 GRAND STREET JERSEY CITY NJ 07302 HUDSON 2019152000 310075 MONMOUTH MEDICAL CENTER 300 SECOND AVENUE LONG BRANCH NJ 07740 MONMOUTH 7322225200 310076 SAINT BARNABAS MEDICAL CENTER 94 OLD SHORT HILLS ROAD LIVINGSTON NJ 07039 ESSEX 9733225000 310081 INSPIRA MEDICAL CENTER WOODBURY 509 N BROAD ST WOODBURY NJ 08096 GLOUCESTER 8568450100 310083 EAST ORANGE GENERAL HOSPITAL 300 CENTRAL AVE EAST ORANGE NJ 07018 ESSEX 9732664401 310084 MONMOUTH MEDICAL CENTER‐SOUTHERN CAMPUS 600 RIVER AVE LAKEWOOD NJ 08701 OCEAN 7323631900 310086 KENNEDY UNIVERSITY HOSPITAL ‐ STRATFORD DIV 18 EAST LAUREL ROAD STRATFORD NJ 08084 CAMDEN 8563467802 310091 MEMORIAL HOSPITAL OF SALEM COUNTY 310 WOODSTOWN ROAD SALEM NJ 08079 SALEM 8569351000 310092 CAPITAL HEALTH SYSTEM‐FULD CAMPUS 750 BRUNSWICK AVE TRENTON NJ 08638 MERCER 6093946000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 134 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 310096 SAINT MICHAEL'S MEDICAL CENTER 111 CENTRAL AVENUE NEWARK NJ 07102 ESSEX 9738775350 310108 JFK MEDICAL CTR ‐ ANTHONY M. YELENCSICS COMMUNITY 65 JAMES STREET EDISON NJ 08818 MIDDLESEX 7323217000
310110 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL ONE HAMILTON HEALTH PLACE HAMILTON NJ 08690 MERCER 6095867900 HAMILTON 310111 CENTRASTATE MEDICAL CENTER 901 WEST MAIN STREET FREEHOLD NJ 07728 MONMOUTH 7324312000 310112 BAYSHORE COMMUNITY HOSPITAL 727 N BEERS ST HOLMDEL NJ 07733 MONMOUTH 7327395900 310113 SOUTHERN OCEAN MEDICAL CENTER 1140 RT 72 W MANAHAWKIN NJ 08050 OCEAN 6095976011 310115 HACKETTSTOWN REGIONAL MEDICAL CENTER 651 WILLOW GROVE ST HACKETTSTOWN NJ 07840 WARREN 9088525100 310118 MEADOWLANDS HOSPITAL MEDICAL CENTER 55 MEADOWLANDS PKWY SECAUCUS NJ 07094 HUDSON 2013923200 310119 UNIVERSITY HOSPITAL 150 BERGEN ST NEWARK NJ 07103 ESSEX 9739725658 310130 HACKENSACK‐UMC AT PASCACK VALLEY 250 OLD HOOK ROAD WESTWOOD NJ 07675 BERGEN 2013831074 312014 MATHENY SCHOOL & HOSPITAL, THE 65 HIGHLAND AVENUE PEAPACK NJ 07977 SOMERSET 9082340011 312017 SPECIALTY HOSPITAL OF CENTRAL JERSEY 600 RIVER AVENUE, 4 WEST LAKEWOOD NJ 08701 OCEAN 7328063207 312018 CARE ONE AT RARITAN BAY MEDICAL CENTER, LLC 530 NEW BRUNSWICK AVENUE, 2ND FLOOR GREEN PERTH AMBOY NJ 08861 MIDDLESEX 7323246090 312019 SELECT SPECIALTY HOSPITAL NORTHEAST 96 PARKWAY ROCHELLE PARK NJ 07662 BERGEN 2012212352 312020 KINDRED HOSPITAL NEW JERSEY ‐ MORRIS COUNTY 400 WEST BLACKWELL STREET DOVER NJ 07801 MORRIS 9735373816 312022 LOURDES SPECIALTY HOSPITAL OF SOUTHERN NEW JERSE 218 SUNSET ROAD WILLINGBORO NJ 08046 BURLINGTON 6098355782
312023 ACUITY SPECIALTY HOSPITAL OF NEW JERSEY 1925 PACIFIC AVENUE 5TH FLOOR ATLANTIC CITY NJ 08401 ATLANTIC 6094412122 312024 COLUMBUS HOSPITAL LTACH 495 NORTH 13TH STREET NEWARK NJ 07107 ESSEX 9735877712 313025 KESSLER INSTITUTE FOR REHABILITATION ‐ WEST FAC 1199 PLEASANT VALLEY WAY WEST ORANGE NJ 07052 ESSEX 9737313600 313027 ST LAWRENCE REHABILITATION CENTER 2381 LAWRENCEVILLE ROAD LAWRENCEVILLE NJ 08648 MERCER 6098969500 313029 HEALTHSOUTH REHABILITATION HOSPITAL OF TOMS RIVER 14 HOSPITAL DRIVE TOMS RIVER NJ 08755 OCEAN 7328443100
313030 BACHARACH INSTITUTE FOR REHABILITATION 61 W JIMMIE LEEDS ROAD POMONA NJ 08240 ATLANTIC 6096527000 313032 MARLTON REHABILITATION HOSPITAL 92 BRICK ROAD MARLTON NJ 08053 BURLINGTON 8569888778 313033 SHORE REHABILITATION INSTITUTE 425 JACK MARTIN BOULEVARD, SECOND FLOOR, EAST BRICK NJ 08724 OCEAN 7328364530 WING 313035 HEALTHSOUTH REHABILITATION HOSPITAL OF TINTON FALL 2 CENTRE PLAZA TINTON FALLS NJ 07724 MONMOUTH 7324605320
313036 HEALTHSOUTH REHABILITATION HOSPITAL OF VINELAND 1237 W SHERMAN AVENUE VINELAND NJ 08360 CUMBERLAND 8566967100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 135 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 313300 CHILDREN'S SPECIALIZED HOSPITAL 200 SOMERSET STREET NEW BRUNSWICK NJ 08901 MIDDLESEX 7322587050 313302 WEISMAN CHILDRENS REHABILITATION HOSPITAL 92 BRICK ROAD, 3RD FLOOR MARLTON NJ 08053 BURLINGTON 8564894520 314001 SUMMIT OAKS HOSPITAL 19 PROSPECT ST SUMMIT NJ 07901 UNION 9085227000 314005 ANCORA PSYCH HOSP ANCORA BRANCH HAMMONTON NJ 08037 ATLANTIC 6095611700 314011 UNIVERSITY BEHAVIORAL HEALTH CARE 671 HOES LANE WEST PISCATAWAY NJ 08854 MIDDLESEX 7322355900 314012 CARRIER CLINIC 252 ROUTE 601 BELLE MEAD NJ 08502 SOMERSET 9082811000 314013 TRENTON PSYCHIATRIC HOSP STATION A TRENTON NJ 08625 MERCER 6096331586 314016 GREYSTONE PARK PSYCH HOSP CENTRAL AVE GREYSTONE PARK NJ 07950 MORRIS 9735381800 314018 NORTHBROOK BEHAVIORAL HEALTH HOSPITAL 425 WOODBURY TURNERSVILLE ROAD BLACKWOOD NJ 08012 CAMDEN 8563746600 314019 RAMAPO RIDGE PSYCH HOSP 301 SICOMAC AVE WYCKOFF NJ 07481 BERGEN 2018485805 314020 ESSEX COUNTY HOSPITAL CENTER 204 GROVE AVENUE CEDAR GROVE NJ 07009 ESSEX 9735712801 314021 HAMPTON BEHAVIORAL HEALTH SYSTEM 650 RANCOCAS ROAD WESTAMPTON NJ 08060 BURLINGTON 6092677000 314022 ST BARNABAS BEHAVIORAL HEALTH CENTER 1691 HIGHWAY 9 ‐ CN2025 TOMS RIVER NJ 08755 OCEAN 7329141688 314023 ASPEN HILLS HEALTHCARE CENTER 600 PEMBERTON‐BROWNS MILLS ROAD PEMBERTON NJ 08068 BURLINGTON 6098366100 314024 HUDSON COUNTY MEADOWVIEW PSYCHIATRIC H 595 COUNTY AVENUE SECAUCUS NJ 07094 HUDSON 2013695252 314026 EAST MOUNTAIN HOSPITAL 40 EAST MOUNTAIN ROAD BELLE MEAD NJ 08502 SOMERSET 9082811500 314027 CORNERSTONE BEHAVIORAL HEALTH HOSPITAL OF UNION 40 WATCHUNG WAY BERKELEY HEIGHTS NJ 07922 UNION 9087715857 CO 319800 OUR LADY OF LOURDES MEDICAL CENTER 1600 HADDON AVENUE CAMDEN NJ 08103 CAMDEN 8567573500 319801 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK NJ 08901 MIDDLESEX 7324188365 319802 HACKENSACK UNIVERSITY MEDICAL CENTER 30 PROSPECT AVE HACKENSACK NJ 07601 BERGEN 2019962608 319803 NEWARK BETH ISRAEL MEDICAL CENTER 201 LYON AVENUE AT OSBORNE TERRACE NEWARK NJ 07112 ESSEX 9733228988 319804 ST BARNABAS MEDICAL CENTER 94 OLD SHORT HILLS ROAD LIVINGSTON NJ 07039 ESSEX 9733225502 319805 UNIVERSITY HOSPITAL, UNIVERSITY OF MEDICINE AND DE 150 BERGEN STREET NEWARK NJ 07103 ESSEX 9739721351
320001 UNM HOSPITAL 2211 LOMAS BOULEVARD NE ALBUQUERQUE NM 87106 BERNALILLO 5052722111 320002 CHRISTUS ST VINCENT REGIONAL MEDICAL CENTER 455 ST MICHAEL'S DRIVE SANTA FE NM 87505 SANTA FE 5059135201 320003 ALTA VISTA REGIONAL HOSPITAL 104 LEGION DRIVE LAS VEGAS NM 87701 SAN MIGUEL 5054263930 320004 GERALD CHAMPION REGIONAL MEDICAL CENTER 2669 NORTH SCENIC DRIVE ALAMOGORDO NM 88310 OTERO 5754396100 320005 SAN JUAN REGIONAL MEDICAL CENTER 801 WEST MAPLE STREET FARMINGTON NM 87401 SAN JUAN 5056092000 320006 EASTERN NEW MEXICO MEDICAL CENTER 405 W COUNTRY CLUB ROAD ROSWELL NM 88201 CHAVES 5756274032
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 136 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 320009 LOVELACE MEDICAL CENTER 601 DR MARTIN LUTHER KING JR AVE NE ALBUQUERQUE NM 87102 BERNALILLO 5057278000 320011 PRESBYTERIAN ESPANOLA HOSPITAL 1010 SPRUCE STREET ESPANOLA NM 87532 RIO ARRIBA 5057531502 320013 HOLY CROSS HOSPITAL A DIV OF TAOS HEALTH SYSTEMS 1397 WEIMER ROAD TAOS NM 87571 TAOS 5757588883
320016 GILA REGIONAL MEDICAL CENTER 1313 E 32ND ST SILVER CITY NM 88061 GRANT 5755384000 320017 LOVELACE WOMEN'S HOSPITAL 4701 MONTGOMERY BOULEVARD NE ALBUQUERQUE NM 87109 BERNALILLO 5057277805 320018 MEMORIAL MEDICAL CENTER INC 2450 SOUTH TELSHOR BLVD LAS CRUCES NM 88011 DO±A ANA 5755228641 32001E CARRIE TINGLEY CRIPPLED CHILDREN HOSP 1400 S BROADWAY TRUTH OR CONSEQUENCES NM 87901 SIERRA 320021 PRESBYTERIAN HOSPITAL 1100 CENTRAL AVENUE SE ALBUQUERQUE NM 87106 BERNALILLO 5057248386 320022 PLAINS REGIONAL MEDICAL CENTER 2100 N MARTIN LUTHER KING, JR, BLVD CLOVIS NM 88101 CURRY 5757697155 32002F US AIR FORCE HOSP ALAMOGORDO NM 88310 OTERO 320030 ARTESIA GENERAL HOSPITAL 702 N 13TH STREET ARTESIA NM 88210 EDDY 5757483333 320033 LOS ALAMOS MEDICAL CENTER 3917 WEST ROAD LOS ALAMOS NM 87544 LOS ALAMOS 5056624201 320038 REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES 1901 RED ROCK DRIVE GALLUP NM 87301 MCKINLEY 5058637000
32003F US PUBLIC HEALTH SERVICE INDIAN HOSP 801 VASSAR DR NE ALBUQUERQUE NM 87106 BERNALILLO 5059845780 32004F US ARMY HOSP SANDIA BASE ALBUQUERQUE NM 87115 BERNALILLO 320057 SANTA FE PHS INDIAN HOSPITAL 1700 CERRILLOS ROAD SANTA FE NM 87501 SANTA FE 5059889821 320058 MESCALERO PHS INDIAN HOSPITAL P O BOX 210 MESCALERO NM 88340 OTERO 5054644441 320059 NORTHERN NAVAJO MEDICAL CENTER US HWY 491 NORTH SHIPROCK NM 87420 SAN JUAN 5053686001 32005F VA HOSP 2100 RIDGECREST DR SE ALBUQUERQUE NM 87101 BERNALILLO 320060 ZUNI COMPREHENSIVE COMMUNITY HEALTH CENTER ROUTE 301 NORTH B STREET ZUNI NM 87327 MCKINLEY 5057824431 320061 GALLUP INDIAN MEDICAL CENTER 516 E NIZHONI BLVD GALLUP NM 87301 MCKINLEY 5057221000 320062 CROWNPOINT HEALTHCARE FACILITY JUNCTION OF HWY 371 CROWNPOINT NM 87313 MCKINLEY 5057865291 320063 CARLSBAD MEDICAL CENTER 2430 WEST PIERCE STREET CARLSBAD NM 88220 EDDY 5758874570 320065 LEA REGIONAL MEDICAL CENTER 5419 N LOVINGTON HIGHWAY HOBBS NM 88240 LEA 5754925000 320067 GUADALUPE COUNTY HOSPITAL 117 CAMINO DE VIDA, SUITE 100 SANTA ROSA NM 88435 GUADALUPE 5754723417 32006F US AIR FORCE HOSP CANNON AFB CLOVIS NM 88101 CURRY 320070 DHHS USPHS INDIAN HEALTH SERVICES EXIT #102 OFF I‐40 1/2 MILE SOUTH SAN FIDEL NM 87049 CIBOLA 5055525300 320074 LOVELACE WESTSIDE HOSPITAL 10501 GOLF COURSE ROAD NW ALBUQUERQUE NM 87114 BERNALILLO 5057272001 32007F US PUBLIC HEALTH SERVICE INDIAN HOSP PO BOX 1337 GALLUP NM 87301 MCKINLEY
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 137 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 320084 ROOSEVELT GENERAL HOSPITAL 42121 US HIGHWAY 70 PORTALES NM 88130 ROOSEVELT 5753591800 320085 MOUNTAIN VIEW REGIONAL MEDICAL CENTER 4311 EAST LOHMAN AVENUE LAS CRUCES NM 88011 DO±A ANA 5755567600 320086 LOVELACE REGIONAL HOSPITAL ‐ ROSWELL 117 EAST 19TH STREET ROSWELL NM 88201 CHAVES 5756277000 320089 UNM SANDOVAL REGIONAL MEDICAL CENTER 3001 BROADMOOR BLVD NE RIO RANCHO NM 87144 SANDOVAL 5052728087 32010F US PUBLIC HEALTH SERVICE INDIAN HOSP P O BOX 68 SHIPROCK NM 87420 SAN JUAN 32011F US AIR FORCE HOSP HOLLOMAN AFB HOLLOMAN AFB NM 88330 OTERO 5755722778 32012F US PUBLIC HEALTH SERVICE INDIAN HOSP P O BOX 358 CROWNPOINT NM 87313 MCKINLEY 5050000000 32013F MCAFEE ARMY HOSP LAS CRUCES NM 88001 DO±A ANA 32025E GUADALUPE GEN HOSP 535 LAKE D00017 SANTA ROSA NM 88435 GUADALUPE 5054723417 32026E LEA GENERAL HOSP 1701 N TURNER ST HOBBS NM 88240 LEA 32027E EUNICE MUNICIPAL HOSP 2201 WEST AVE O‐BOX 827 EUNICE NM 88231 LEA 32028E GUADALUPE GENERAL HOSP 535 LAKE DR SANTA ROSA NM 88435 GUADALUPE 32031E COLFAX GEN HOSP 615 PROSPECT AVE BOX 458 SPRINGER NM 87747 COLFAX 5050000000 321300 SIERRA VISTA HOSPITAL 800 EAST 9TH STREET T OR C NM 87901 SIERRA 5758942111 321301 SOCORRO GENERAL HOSPITAL 1202 HIGHWAY 60 WEST SOCORRO NM 87801 SOCORRO 5758358700 321302 DR DAN C TRIGG MEMORIAL HOSPITAL 301 EAST MIEL DE LUNA TUCUMCARI NM 88401 QUAY 5754617007 321304 UNION COUNTY GENERAL HOSPITAL 300 WILSON STREET CLAYTON NM 88415 UNION 5753747001 321305 NOR‐LEA HOSPITAL DISTRICT 1600 NORTH MAIN AVE LOVINGTON NM 88260 LEA 5753966611 321306 LINCOLN COUNTY MEDICAL CENTER 211 SUDDERTH DRIVE RUIDOSO NM 88345 LINCOLN 5752578200 321307 MINERS' COLFAX MEDICAL CENTER 203 HOSPITAL DRIVE RATON NM 87740 COLFAX 5754453661 321308 CIBOLA GENERAL HOSPITAL 1016 E ROOSEVELT AVENUE GRANTS NM 87020 CIBOLA 5052874446 321309 MIMBRES MEMORIAL HOSPITAL 900 W ASH DEMING NM 88031 LUNA 5755465803 322002 KINDRED HOSPITAL ALBUQUERQUE 700 HIGH STREET NE ALBUQUERQUE NM 87102 BERNALILLO 5052424444 322003 ALBUQUERQUE ‐ AMG SPECIALTY HOSPITAL, LLC 235 ELM STREET NE ALBUQUERQUE NM 87102 BERNALILLO 5058425550 322004 ADVANCED CARE HOSPITAL OF SOUTHERN NEW MEXICO 4451 EAST LOHMAN AVENUE LAS CRUCES NM 88011 DO±A ANA 5755216600 LLC 323026 NEW MEXICO REHABILITATION CENTER 72 GAIL HARRIS AVENUE ROSWELL NM 88203 CHAVES 5753473400 323027 HEALTHSOUTH REHABILITATION HOSPITAL 7000 JEFFERSON STREET NE ALBUQUERQUE NM 87109 BERNALILLO 5053449478 323028 LOVELACE REHABILITATION HOSPITAL 505 ELM STREET NE ALBUQUERQUE NM 87102 BERNALILLO 5057274781 323029 SAN JUAN REGIONAL REHABILITATION HOSPITAL INC 525 SOUTH SCHWARTZ AVENUE FARMINGTON NM 87401 SAN JUAN 5056092625
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 138 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 323032 REHABILITATION HOSPITAL OF SOUTHERN NEW 4441 EAST LOHMAN AVENUE LAS CRUCES NM 88011 DO±A ANA 5755216400 MEXICO,INC 324010 BHC MESILLA VALLEY HOSPITAL, LLC 3751 DEL REY BOULEVARD LAS CRUCES NM 88012 DO±A ANA 5753823500 324012 PEAK BEHAVIORAL HEALTH SERVICES, LLC 5065 MCNUTT ROAD (BLDG'S A,B & C) SANTA TERESA NM 88008 DO±A ANA 5755893000 324013 HAVEN BEHAVIORAL HOSPITAL OF ALBUQUERQUE 5400 GIBSON BOULEVARD SE, 4TH FLOOR ALBUQUERQUE NM 87108 BERNALILLO 5052544503 324014 CENTRAL DESERT BEHAVIORAL HEALTH CENTER 239 ELM STREET NE ALBUQUERQUE NM 87102 BERNALILLO 5052433387 329801 PRESBYTERIAN HEALTHCARE TRANSPLANT 1100 CENTRAL SE ALBUQUERQUE NM 87102 BERNALILLO 5058411275 329802 UNIVERSITY HOSPITAL, UNIVERSITY OF NEW MEXICO HEAL 2211 LOMAS BOULEVARD NE ALBUQUERQUE NM 87106 BERNALILLO 5052722583
330003 ALBANY MEMORIAL HOSPITAL 600 NORTHERN BOULEVARD ALBANY NY 12204 ALBANY 5184713221 330004 HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS 396 BROADWAY KINGSTON NY 12401 ULSTER 9143313131 330005 KALEIDA HEALTH 726 EXCHANGE STREET, SUITE 522 BUFFALO NY 14210 ERIE 7168598620 330006 ST JOSEPH'S MEDICAL CENTER 127 SOUTH BROADWAY YONKERS NY 10701 WESTCHESTER 9143787000 330008 WYOMING COUNTY COMMUNITY HOSPITAL 400 NORTH MAIN STREET WARSAW NY 14569 WYOMING 5857862233 330009 BRONX‐LEBANON HOSPITAL CENTER 1276 FULTON AVENUE BRONX NY 10456 2125887000 330011 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC 169 RIVERSIDE DRIVE BINGHAMTON NY 13905 BROOME 6077985111 330013 ALBANY MEDICAL CENTER HOSPITAL 43 NEW SCOTLAND AVENUE ALBANY NY 12208 ALBANY 5182623000 330014 JAMAICA HOSPITAL MEDICAL CENTER 89TH AVENUE AND VAN WYCK EXPRESSWAY JAMAICA NY 11418 7182626000 330019 NEW YORK COMMUNITY HOSPITAL OF BROOKLYN, INC. 2525 KINGS HIGHWAY BROOKLYN NY 11229 7186925302
330023 VASSAR BROTHERS MEDICAL CENTER 45 READE PLACE POUGHKEEPSIE NY 12601 DUTCHESS 8454548500 330024 MOUNT SINAI HOSPITAL ONE GUSTAVE L LEVY PLACE NEW YORK NY 10029 2122417981 330027 NASSAU UNIVERSITY MEDICAL CENTER 2201 HEMPSTEAD TURNPIKE EAST MEADOW NY 11554 NASSAU 5165720123 330028 RICHMOND UNIVERSITY MEDICAL CENTER 355 BARD AVENUE STATEN ISLAND NY 10304 7188181234 330030 NEWARK‐WAYNE COMMUNITY HOSPITAL 111 DRIVING PARK AVENUE NEWARK NY 14513 WAYNE 3153322022 330033 CHENANGO MEMORIAL HOSPITAL, INC 179 NORTH BROAD STREET NORWICH NY 13815 CHENANGO 6073354111 330037 LAKESIDE MEMORIAL HOSPITAL 156 WEST AVENUE BROCKPORT NY 14420 MONROE 5856373131 330043 SOUTHSIDE HOSPITAL 301 EAST MAIN STREET BAY SHORE NY 11706 SUFFOLK 6319683000 330044 FAXTON‐ST LUKE'S HEALTHCARE 1656 CHAMPLIN AVENUE UTICA NY 13503 ONEIDA 3157986000 330045 HUNTINGTON HOSPITAL 270 PARK AVENUE HUNTINGTON NY 11743 SUFFOLK 6313512000 330046 ST LUKE'S ROOSEVELT HOSPITAL 1000 TENTH AVENUE NEW YORK NY 10019 2125234000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 139 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 330047 ST MARY'S HOSPITAL AT AMSTERDAM 427 GUY PARK AVENUE AMSTERDAM NY 12010 MONTGOMERY 5188417101 330049 NORTHERN DUTCHESS HOSPITAL 6511 SPRINGBROOK AVENUE RHINEBECK NY 12572 DUTCHESS 8458713391 330053 MEDINA MEMORIAL HOSPITAL 200 OHIO STREET MEDINA NY 14103 ORLEANS 5857988111 330055 NEWYORK‐PRESBYTERIAN/QUEENS 56‐45 MAIN STREET FLUSHING NY 11355 7186702000 330056 BROOKLYN HOSPITAL CENTER AT DOWNTOWN CAMPUS 121 DEKALB AVENUE BROOKLYN NY 11201 7182508000
330057 ST PETER'S HOSPITAL 315 SOUTH MANNING BOULEVARD ALBANY NY 12208 ALBANY 5185251550 330058 GENEVA GENERAL HOSPITAL 196 ‐198 NORTH STREET GENEVA NY 14456 ONTARIO 3157874175 330059 MONTEFIORE MEDICAL CENTER 111 EAST 210TH STREET BRONX NY 10467 7189204321 330061 LAWRENCE HOSPITAL CENTER 55 PALMER AVENUE BRONXVILLE NY 10708 WESTCHESTER 9147871000 330064 NEW YORK DOWNTOWN HOSPITAL 170 WILLIAM STREET NEW YORK NY 10038 2123125000 330065 NIAGARA FALLS MEMORIAL MEDICAL CENTER 621 TENTH STREET NIAGARA FALLS NY 14302 NIAGARA 7162784000 330066 ST CLARE'S HOSPITAL 600 MCCLELLAN STREET SCHENECTADY NY 12304 SCHENECTADY 5183822000 330067 ST FRANCIS HOSPITAL 241 NORTH ROAD POUGHKEEPSIE NY 12601 DUTCHESS 8454835000 330073 UNITED MEMORIAL MEDICAL CENTER 127 NORTH STREET BATAVIA NY 14020 GENESEE 5853436030 330074 F F THOMPSON HOSPITAL 350 PARRISH STREET CANANDAIGUA NY 14424 ONTARIO 5853966000 330078 SISTERS OF CHARITY HOSPITAL 2157 MAIN STREET BUFFALO NY 14214 ERIE 7168621000 330079 ADIRONDACK MEDICAL CENTER 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 FRANKLIN 5188914141 330080 LINCOLN MEDICAL & MENTAL HEALTH CENTER 234 EAST 149TH STREET BRONX NY 10451 7185795000 330084 ALICE HYDE MEDICAL CENTER 133 PARK STREET MALONE NY 12953 FRANKLIN 5184833000 330085 AURELIA OSBORN FOX MEMORIAL HOSPITAL ONE NORTON AVENUE ONEONTA NY 13820 OTSEGO 6074322000 330086 MONTEFIORE MOUNT VERNON HOSPITAL 12 NORTH 7TH AVENUE MOUNT VERNON NY 10550 WESTCHESTER 9146648000 330088 EASTERN LONG ISLAND HOSPITAL 201 MANOR PLACE GREENPORT NY 11944 SUFFOLK 6314771000 330090 ARNOT OGDEN MEDICAL CENTER 600 ROE AVENUE ELMIRA NY 14905 CHEMUNG 6077374100 330094 COLUMBIA MEMORIAL HOSPITAL 71 PROSPECT AVENUE HUDSON NY 12534 COLUMBIA 5188287601 330096 JONES MEMORIAL HOSPITAL 191 NORTH MAIN STREET WELLSVILLE NY 14895 ALLEGANY 5855931100 33009F VA HOSP 113 HOLLAND AVE ALBANY NY 12208 ALBANY 330100 N Y EYE AND EAR INFIRMARY 230 SECOND AVE NEW YORK NY 10003 2129794000 330101 NEW YORK‐PRESBYTERIAN HOSPITAL 525 EAST 68TH STREET NEW YORK NY 10021 2127464189 330102 KENMORE MERCY HOSPITAL 2950 ELMWOOD AVENUE KENMORE NY 14217 ERIE 7164476100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 140 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 330103 OLEAN GENERAL HOSPITAL 515 MAIN STREET OLEAN NY 14760 CATTARAUGUS 7163732600 330104 NYACK HOSPITAL 160 NORTH MIDLAND AVENUE NYACK NY 10960 ROCKLAND 8453482000 330106 NORTH SHORE UNIVERSITY HOSPITAL 300 COMMUNITY DRIVE MANHASSET NY 11030 NASSAU 5165620100 330107 PECONIC BAY MEDICAL CENTER 1300 ROANOKE AVENUE RIVERHEAD NY 11901 SUFFOLK 6315486000 330108 ST JOSEPH'S HOSPITAL, INC 555 ST JOSEPH'S BLVD ELMIRA NY 14902 CHEMUNG 6077336541 33010F VA HOSP BATAVIA NY 14020 GENESEE 330111 BERTRAND CHAFFEE HOSPITAL 224 EAST MAIN STREET SPRINGVILLE NY 14141 ERIE 7165922871 330115 ONEIDA HEALTHCARE 321 GENESEE STREET ONEIDA NY 13421 MADISON 3153636000 330119 LENOX HILL HOSPITAL 100 EAST 77TH STREET NEW YORK NY 10021 2124392345 33011F VA HOSP BATH NY 14810 STEUBEN 330125 ROCHESTER GENERAL HOSPITAL 1425 PORTLAND AVENUE ROCHESTER NY 14621 MONROE 5859224000 330126 ORANGE REGIONAL MEDICAL CENTER 707 EAST MAIN STREET MIDDLETOWN NY 10940 ORANGE 8453432424 330127 JACOBI MEDICAL CENTER 1400 PELHAM PARKWAY SOUTH BRONX NY 10461 7189185000 330128 ELMHURST HOSPITAL CENTER 79‐01 BROADWAY ELMHURST NY 11373 7183341141 33012F VA HOSP 3495 BAILEY AVE BUFFALO NY 14215 ERIE 330132 TLC HEALTH NETWORK 845 ROUTES 5 AND 20 IRVING NY 14081 CHAUTAUQUA 7165323377 330135 BON SECOURS COMMUNITY HOSPITAL 160 EAST MAIN STREET PORT JERVIS NY 12771 ORANGE 8458565351 330136 MARY IMOGENE BASSETT HOSPITAL ONE ATWELL ROAD COOPERSTOWN NY 13326 OTSEGO 6075473456 33013F VA HOSP FT HILL AVE CANANDAIGUA NY 14424 ONTARIO 330140 ST JOSEPH'S HOSPITAL HEALTH CENTER 301 PROSPECT AVENUE SYRACUSE NY 13203 ONONDAGA 3154485111 330141 BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER 101 HOSPITAL ROAD PATCHOGUE NY 11772 SUFFOLK 6316547100
330144 IRA DAVENPORT MEMORIAL HOSPITAL, INC 7571 STATE ROUTE 54 BATH NY 14810 STEUBEN 6077768500 33014F VA HOSP CASTLE POINT NY 12511 DUTCHESS 330151 ST JAMES MERCY HOSPITAL 411 CANISTEO STREET HORNELL NY 14843 STEUBEN 6073248000 330153 ELLIS HOSPITAL 1101 NOTT STREET SCHENECTADY NY 12308 SCHENECTADY 5182434000 330154 MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES 1275 YORK AVENUE NEW YORK NY 10021 2126392000
330157 SAMARITAN MEDICAL CENTER 830 WASHINGTON STREET WATERTOWN NY 13601 JEFFERSON 3157854121 330158 GOOD SAMARITAN HOSPITAL OF SUFFERN 255 LAFAYETTE AVENUE SUFFERN NY 10901 ROCKLAND 9143685000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 141 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 330159 COMMUNITY‐GENERAL HOSPITAL OF GREATER SYRACUSE 4900 BROAD ROAD SYRACUSE NY 13215 ONONDAGA 3154925011
33015F VA HOSP MONTROSE NY 10548 WESTCHESTER 330160 STATEN ISLAND UNIVERSITY HOSPITAL 475 SEAVIEW AVENUE STATEN ISLAND NY 10305 7182269000 330162 NORTHERN WESTCHESTER HOSPITAL 400 EAST MAIN STREET MOUNT KISCO NY 10549 WESTCHESTER 9146661200 330163 EASTERN NIAGARA HOSPITAL 521 EAST AVENUE LOCKPORT NY 14094 NIAGARA 7165145700 330164 HIGHLAND HOSPITAL 1000 SOUTH AVENUE ROCHESTER NY 14620 MONROE 5854732200 330166 WESTFIELD MEMORIAL HOSPITAL, INC 189 EAST MAIN STREET WESTFIELD NY 14787 CHAUTAUQUA 7163264921 330167 WINTHROP‐UNIVERSITY HOSPITAL 259 FIRST STREET MINEOLA NY 11501 NASSAU 5166630333 330169 MOUNT SINAI BETH ISRAEL/PETRIE CAMPUS FIRST AVENUE AT 16TH STREET NEW YORK NY 10003 2124202000 33016F VA HOSP 130 W KINGSBRIDGE RD BRONX NY 10468 330175 CORTLAND REGIONAL MEDICAL CENTER, INC 134 HOMER AVENUE CORTLAND NY 13045 CORTLAND 6077563500 33017F VA HOSP 1ST AVE + E 24TH ST NEW YORK NY 10010 330180 SAMARITAN HOSPITAL 2215 BURDETT AVENUE TROY NY 12180 RENSSELAER 5182713300 330181 GLEN COVE HOSPITAL 101 ST ANDREWS LANE GLEN COVE NY 11542 NASSAU 5166747300 330182 ST FRANCIS HOSPITAL, ROSLYN 100 PORT WASHINGTON BOULEVARD ROSLYN NY 11576 NASSAU 5165626000 330184 MONTEFIORE NEW ROCHELLE HOSPITAL 16 GUION PLACE NEW ROCHELLE NY 10802 WESTCHESTER 9146325000 330185 JOHN T MATHER MEMORIAL HOSPITAL OF PORT 75 NORTH COUNTRY ROAD PORT JEFFERSON NY 11777 SUFFOLK 6314731320 JEFFERSON 330188 MOUNT ST MARY'S HOSPITAL AND HEALTH CENTER 5300 MILITARY ROAD LEWISTON NY 14092 NIAGARA 7162974800 330189 ALBANY MEDICAL CENTER / SOUTH CLINICAL CAMPUS 25 HACKETT BOULEVARD ALBANY NY 12208 ALBANY 5182623000
33018F US NAVAL HOSP LINDEN BLVD SAINT ALBANS NY 11425 330191 GLENS FALLS HOSPITAL 100 PARK STREET GLENS FALLS NY 12801 WARREN 5189261000 330193 FLUSHING HOSPITAL MEDICAL CENTER 45TH AVENUE AND PARSONS BOULEVARD FLUSHING NY 11355 7186705000 330194 MAIMONIDES MEDICAL CENTER 4802 TENTH AVENUE BROOKLYN NY 11219 7182836000 330195 LONG ISLAND JEWISH MEDICAL CENTER 270 ‐ 05 76TH AVENUE NEW HYDE PARK NY 11040 7184707000 330196 CONEY ISLAND HOSPITAL 2601 OCEAN PARKWAY BROOKLYN NY 11235 7186163000 330197 CANTON‐POTSDAM HOSPITAL 50 LEROY STREET POTSDAM NY 13676 ST. LAWRENCE 3152653300 330198 SOUTH NASSAU COMMUNITIES HOSPITAL ONE HEALTHY WAY OCEANSIDE NY 11572 NASSAU 5166323000 330199 METROPOLITAN HOSPITAL CENTER 1901 FIRST AVENUE NEW YORK NY 10029 2124236262
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 142 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 33019F VA HOSP 79 MIDDLEVILLE RD NORTHPORT NY 11768 SUFFOLK 6312614400 330201 KINGSBROOK JEWISH MEDICAL CENTER 585 SCHENECTADY AVENUE BROOKLYN NY 11203 7186045789 330202 KINGS COUNTY HOSPITAL CENTER 451 CLARKSON AVENUE BROOKLYN NY 11203 7182453901 330203 CROUSE HOSPITAL 736 IRVING AVENUE SYRACUSE NY 13210 ONONDAGA 3154707449 330204 BELLEVUE HOSPITAL CENTER 462 FIRST AVENUE NEW YORK NY 10016 2125614132 330205 ST ANTHONY COMMUNITY HOSPITAL 15 ‐ 19 MAPLE AVENUE WARWICK NY 10990 ORANGE 8459862276 330208 ST JOHN'S RIVERSIDE HOSPITAL 976 NORTH BROADWAY YONKERS NY 10701 WESTCHESTER 9149644444 33020F VA HOSP 800 POLY PL BROOKLYN NY 11209 330211 CLAXTON‐HEPBURN MEDICAL CENTER 214 KING STREET OGDENSBURG NY 13669 ST. LAWRENCE 3153933600 330214 NYU HOSPITALS CENTER 550 FIRST AVENUE NEW YORK NY 10016 2122637300 330215 ROME MEMORIAL HOSPITAL, INC 1500 NORTH JAMES STREET ROME NY 13440 ONEIDA 3153387000 330218 OSWEGO HOSPITAL 110 WEST SIXTH STREET OSWEGO NY 13126 OSWEGO 3153495511 330219 ERIE COUNTY MEDICAL CENTER 462 GRIDER STREET BUFFALO NY 14215 ERIE 7168983936 33021F US PUBLIC HEALTH SERVICE HOSP BAY + VANDERBILT STS STATEN ISLAND NY 10301 330221 WYCKOFF HEIGHTS MEDICAL CENTER 374 STOCKHOLM STREET BROOKLYN NY 11237 7189637272 330222 SARATOGA HOSPITAL 211 CHURCH STREET SARATOGA SPRINGS NY 12866 SARATOGA 5185873222 330223 MASSENA MEMORIAL HOSPITAL 1 HOSPITAL DRIVE MASSENA NY 13662 ST. LAWRENCE 3157641711 330224 HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS 105 MARY'S AVENUE KINGSTON NY 12401 ULSTER 8453382500
330226 UNITY HOSPITAL OF ROCHESTER 1555 LONG POND ROAD ROCHESTER NY 14626 MONROE 5857237000 330229 BROOKS MEMORIAL HOSPITAL 529 CENTRAL AVENUE DUNKIRK NY 14048 CHAUTAUQUA 7163661111 33022F US AIR FORCE HOSP PLATTSBURGH AFB PLATTSBURGH NY 12903 CLINTON 330231 QUEENS HOSPITAL CENTER 82‐68 164TH STREET JAMAICA NY 11432 7188833000 330232 ST MARY'S HOSPITAL ( TROY ) 1300 MASSACHUSETTS AVENUE TROY NY 12180 RENSSELAER 5182685000 330233 BROOKDALE HOSPITAL MEDICAL CENTER 1 BROOKDALE PLAZA BROOKLYN NY 11212 7182405966 330234 WESTCHESTER MEDICAL CENTER 100 WOODS RD VALHALLA NY 10595 WESTCHESTER 9142857017 330235 AUBURN COMMUNITY HOSPITAL 17 LANSING STREET AUBURN NY 13021 CAYUGA 3152557011 330236 NEW YORK METHODIST HOSPITAL 506 SIXTH STREET BROOKLYN NY 11215 7187803000 330238 NICHOLAS H NOYES MEMORIAL HOSPITAL 111 CLARA BARTON STREET DANSVILLE NY 14437 LIVINGSTON 5853356001 330239 WOMAN'S CHRISTIAN ASSOCIATION 207 FOOTE AVENUE JAMESTOWN NY 14701 CHAUTAUQUA 7164870141
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 143 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 33023F US AIR FORCE HOSP GRIFFISS AFB ROME NY 13440 ONEIDA 330240 HARLEM HOSPITAL CENTER 506 LENOX AVENUE NEW YORK NY 10037 2124918400 330241 UNIVERSITY HOSPITAL S U N Y HEALTH SCIENCE CENTER 750 EAST ADAMS STREET SYRACUSE NY 13210 ONONDAGA 3154734240
330245 ST ELIZABETH MEDICAL CENTER 2209 GENESEE STREET UTICA NY 13501 ONEIDA 3157988100 330246 ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 SUFFOLK 6314746000 33024F VA HOSP IRVING AVE + UNIVERSITY PLACE SYRACUSE NY 13210 ONONDAGA 330250 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR 75 BEEKMAN STREET PLATTSBURGH NY 12901 CLINTON 5185627767
330259 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 NASSAU 5167052525 33025F US ARMY HOSP US MILITARY ACADEMY WEST POINT NY 10996 ORANGE 330261 PHELPS MEMORIAL HOSPITAL ASSN 701 NORTH BROADWAY SLEEPY HOLLOW NY 10591 WESTCHESTER 9143663000 330264 ST LUKE'S CORNWALL HOSPITAL 70 DUBOIS STREET NEWBURGH NY 12550 ORANGE 8455614400 330265 CLIFTON SPRINGS HOSPITAL AND CLINIC 2 COULTER ROAD CLIFTON SPRINGS NY 14432 ONTARIO 3154629561 330267 NEW YORK‐PRESBYTERIAN/HUDSON VALLEY HOSPITAL 1980 CROMPOND ROAD CORTLANDT MANOR NY 10567 WESTCHESTER 9147343611
330268 COBLESKILL REGIONAL HOSPITAL 178 GRANDVIEW DRIVE COBLESKILL NY 12043 SCHOHARIE 5182543300 330270 HOSPITAL FOR SPECIAL SURGERY 535 EAST 70TH STREET NEW YORK NY 10021 2126061000 330273 PUTNAM HOSPITAL CENTER 670 STONELEIGH AVENUE CARMEL NY 10512 PUTNAM 9142795711 330276 NATHAN LITTAUER HOSPITAL 99 EAST STATE STREET GLOVERSVILLE NY 12078 FULTON 5187258621 330277 CORNING HOSPITAL 1 GUTHRIE DRIVE CORNING NY 14830 STEUBEN 6079377200 330279 MERCY HOSPITAL OF BUFFALO 565 ABBOTT ROAD BUFFALO NY 14220 ERIE 7168267000 330285 STRONG MEMORIAL HOSPITAL 601 ELMWOOD AVE ROCHESTER NY 14642 MONROE 5852752121 330286 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 SUFFOLK 6313763000 330290 SVCMC‐ST VINCENT'S CTRS NY & WEST BRANCHES 170 WEST 12TH STREET NEW YORK NY 10011 2126047000 330304 WHITE PLAINS HOSPITAL CENTER 41 EAST POST R0AD WHITE PLAINS NY 10601 WESTCHESTER 9146810600 330306 LUTHERAN MEDICAL CENTER 150 55TH STREET BROOKLYN NY 11220 7186308000 330307 CAYUGA MEDICAL CENTER AT ITHACA 101 DATES DRIVE ITHACA NY 14850 TOMPKINS 6072744401 330331 PLAINVIEW HOSPITAL 888 OLD COUNTRY ROAD PLAINVIEW NY 11803 NASSAU 5167193000 330332 ST JOSEPH HOSPITAL 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 NASSAU 5165796000 330340 SOUTHAMPTON HOSPITAL 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 SUFFOLK 5167268200
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 144 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 330350 UNIVERSITY HOSPITAL OF BROOKLYN ( DOWNSTATE ) 445 LENOX ROAD BROOKLYN NY 11203 7182701000 330354 ROSWELL PARK CANCER INSTITUTE ELM AND CARLTON STREETS BUFFALO NY 14203 ERIE 7168452300 330385 NORTH CENTRAL BRONX HOSPITAL 3424 KOSSUTH AVENUE & 210TH STREET BRONX NY 10467 2125195000 330386 CATSKILL REGIONAL MEDICAL CENTER 68 HARRIS BUSHVILLE ROAD HARRIS NY 12742 SULLIVAN 8457943300 330387 ROCKEFELLER UNIVERSITY HOSPITAL 1230 YORK AVENUE NEW YORK NY 10021 2125708000 330390 NORTH GENERAL HOSPITAL 1879 MADISON AVENUE NEW YORK NY 10035 2126504000 330393 UNIVERSITY HOSPITAL ( STONY BROOK )HEALTH SCIENCES CENTER SUNY STONY BROOK NY 11794 SUFFOLK 6314444000 330394 UNITED HEALTH SERVICES HOSPITALS, INC 10‐42 MITCHELL AVENUE BINGHAMTON NY 13903 BROOME 6077636000 330395 ST JOHN'S EPISCOPAL HOSPITAL AT SOUTH SHORE 327 BEACH 19TH STREET FAR ROCKAWAY NY 11691 7188697000 330396 WOODHULL MEDICAL AND MENTAL HEALTH CENTER 760 BROADWAY BROOKLYN NY 11206 7189638100 330397 INTERFAITH MEDICAL CENTER 1545 ATLANTIC AVENUE BROOKLYN NY 11213 7186134000 330399 ST BARNABAS HOSPITAL 4422 THIRD AVENUE BRONX NY 10457 2129609000 330401 ST CATHERINE OF SIENA HOSPITAL 50 ROUTE 25A SMITHTOWN NY 11787 SUFFOLK 6318623000 330403 MONROE COMMUNITY HOSPITAL 435 EAST HENRIETTA ROAD ROCHESTER NY 14620 MONROE 5857606500 330405 HELEN HAYES HOSPITAL 51 NORTH ROUTE 9W WEST HAVERSTRAW NY 10993 ROCKLAND 8457864000 330406 SUNNYVIEW HOSPITAL AND REHABILITATION CENTER 1270 BELMONT AVENUE SCHENECTADY NY 12308 SCHENECTADY 5183863580
330408 TRI‐TOWN REGIONAL HEALTHCARE 43 WEST PEARL STREET SIDNEY NY 13838 DELAWARE 6075637080 330409 BURDETT CARE CENTER 2215 BURDETT AVE TROY NY 12180 RENSSELAER 5182713655 331301 CUBA MEMORIAL HOSPITAL, INC 140 WEST MAIN STREET CUBA NY 14727 ALLEGANY 5859612000 331302 ELIZABETHTOWN COMMUNITY HOSPITAL 75 PARK STREET ELIZABETHTOWN NY 12932 ESSEX 5188736377 331303 CATSKILL REGIONAL MEDICAL CENTER ‐ G HERMANN SITE 8081 ROUTE 97 CALLICOON NY 12723 SULLIVAN 8458875530
331304 MARGARETVILLE MEMORIAL HOSPITAL 42084 STATE HIGHWAY 28 MARGARETVILLE NY 12455 DELAWARE 8455862631 331305 O'CONNOR HOSPITAL 460 ANDES ROAD DELHI NY 13753 DELAWARE 6077460300 331306 MOSES‐LUDINGTON HOSPITAL 1019 WICKER STREET TICONDEROGA NY 12883 ESSEX 5185853700 331307 CLIFTON FINE HOSPITAL 1014 OSWEGATCHIE TRAIL STAR LAKE NY 13690 ST. LAWRENCE 3158483351 331309 RIVER HOSPITAL, INC 4 FULLER STREET ALEXANDRIA BAY NY 13607 JEFFERSON 3154822511 331310 ELLENVILLE REGIONAL HOSPITAL 10 HEALTHY WAY ELLENVILLE NY 12428 ULSTER 8456476400 331311 LITTLE FALLS HOSPITAL 140 BURWELL STREET LITTLE FALLS NY 13365 HERKIMER 3158235261 331312 DELAWARE VALLEY HOSPITAL, INC 1 TITUS PLACE WALTON NY 13856 DELAWARE 6078652188
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 145 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 331313 SCHUYLER HOSPITAL, INC 220 STEUBEN STREET MONTOUR FALLS NY 14865 SCHUYLER 6075307121 331314 SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES 418 NORTH MAIN STREET PENN YAN NY 14527 YATES 3157874175
331315 GOUVERNEUR HOSPITAL 77 WEST BARNEY STREET GOUVERNEUR NY 13642 ST. LAWRENCE 3152871000 331316 COMMUNITY MEMORIAL HOSPITAL, INC 150 BROAD STREET HAMILTON NY 13346 MADISON 3158241100 331317 LEWIS COUNTY GENERAL HOSPITAL 7785 NORTH STATE STREET LOWVILLE NY 13367 LEWIS 3153765200 331318 CARTHAGE AREA HOSPITAL, INC 1001 WEST STREET CARTHAGE NY 13619 JEFFERSON 3154931000 331319 MEDINA MEMORIAL HOSPITAL 200 OHIO STREET MEDINA NY 14103 ORLEANS 5857988111 331990 HIGH RIDGE HOUSE 5959 INDEPENDENCE AVENUE BRONX NY 10471 7187964200 332006 CALVARY HOSPITAL INC 1740 ‐ 70 EASTCHESTER R0AD BRONX NY 10461 7188636900 332008 COLER‐GOLDWATER SPECIALTY HOSPITAL 1752 PARK AVENUE NEW YORK NY 10035 2123188000 332014 SUMMIT PARK HOSPITAL ‐ ROCKLAND COUNTY INFIRMARY SANATORIUM ROAD POMONA NY 10970 ROCKLAND 9143642700
332022 TERENCE CARDINAL COOKE HEALTH CARE CENTER 1249 FIFTH AVENUE NEW YORK NY 10029 2123603600 333030 WINIFRED MASTERSON BURKE REHABILITATION HOSPITAL 785 MAMARONECK AVENUE WHITE PLAINS NY 10605 WESTCHESTER 9145972232
333301 BLYTHEDALE CHILDREN'S HOSPITAL 95 BRADHURST AVENUE VALHALLA NY 10595 WESTCHESTER 9145927555 334001 HUTCHINGS PSYCHIATRIC CTR 620 MADISON STREET SYRACUSE NY 13210 ONONDAGA 3154734980 334002 FOUR WINDS 800 CROSS RIVER RD KATONAH NY 10536 WESTCHESTER 9147638151 334003 ST LAWRENCE PSYCH CENTER ONE CHIMNEY POINT DRIVE OGDENSBURG NY 13669 ST. LAWRENCE 3155412071 334004 CREEDMOOR PSYCHIATRIC CENTER 80‐45 WINCHESTER BLVD BLDG B QUEENS VILLAGE NY 11427 7182644000 334009 NEW YORK STATE PSYCHIATRIC INSTITUTE 722 W 168TH ST NEW YORK NY 10032 2125435000 334012 GREATER BINGHAMTON HEALTH CENTER 425 ROBINSON ST BINGHAMTON NY 13901 BROOME 6077241391 334013 PILGRIM PSYCHIATRIC CENTER 998 CROOKED HILL ROAD WEST BRENTWOOD NY 11717 SUFFOLK 6317613500 334015 ROCKLAND PSYCH CTR 140 OLD ORANGEBURG RD ORANGEBURG NY 10962 ROCKLAND 8453591000 334020 ROCHESTER PSYCHIATRIC CENTER 1600 SOUTH AVE ROCHESTER NY 14620 MONROE 5852411200 334021 MOHAWK VALLEY PSYCHIATRIC CENTER 1400 NOYES ST UTICA NY 13502 ONEIDA 3157976800 334022 BRYLIN HOSP 1263 DELAWARE AVE BUFFALO NY 14209 ERIE 7168868200 334026 BRUNSWICK PSYCH CENTER 366 BROADWAY AMITYVILLE NY 11701 SUFFOLK 5167897000 334027 SOUTH OAKS HOSP 400 SUNRISE HIGHWAY AMITYVILLE NY 11701 SUFFOLK 5162644000 334043 SOUTH BEACH PSYCHIATRIC CENTER 777 SEAVIEW AVE STATEN ISLAND NY 10305 7186672300
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 146 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 334045 ELMIRA PSYCH CENTER WASHINGTON ST ELMIRA NY 14901 CHEMUNG 6077374739 334046 CAPITAL DISTRICT PSYCH CENTER 75 NEW SCOTLAND AVE ALBANY NY 12208 ALBANY 8453985566 334048 GRACIE SQUARE HOSP 420 EAST 76 ST NEW YORK NY 10021 2124345322 334049 FOUR WINDS OF SARATOGA 30 CRESCENT AVE SARATOGA SPRINGS NY 12866 SARATOGA 5185843600 334052 BUFFALO PSYCHIATRIC CENTER 400 FOREST AVE BUFFALO NY 14213 ERIE 7168852261 334053 BRONX PSYCHIATRIC CENTER 1500 WATERS PLACE BRONX NY 10461 7189310600 334054 MANHATTAN PSYCHIATRIC CENTER WARD'S ISLAND NEW YORK NY 10035 2123690500 334055 HOLLISWOOD HOSPITAL,THE 87‐37 PALERMO STREET HOLLIS NY 11423 7187768181 334059 STONEY LODGE HOSPITAL 40 CROTON DAM ROAD OSSINING NY 10562 WESTCHESTER 9149417400 334060 KIRBY FORENSIC PSYCHIATRIC CENTER WARD ISLAND NEW YORK NY 10035 2124279003 334061 MID HUDSON FORENSIC PSYCHIATRIC CTR BOX 158 ROUTE 17M NEW HAMPTON NY 10958 ORANGE 8453743171 334063 KINGSBORO PSYCHIATRIC HOSPITAL 681 CLARKSON AVENUE BROOKLYN NY 11203 7182217395 334064 SAGAMORE CHILDREN'S PSYCHIATRIC CENTER 197 HALF HOLLOW ROAD DIX HILLS NY 11746 SUFFOLK 6313701701 339800 UNIVERSITY HOSPITAL S U N Y HEALTH SCIENCE CTR T C 750 EAST ADAMS STREET SYRACUSE NY 13210 ONONDAGA 3154734240
339801 NORTH SHORE UNIVERSITY HOSPITAL ‐ MANHASSET T C 300 COMMUNITY DRIVE MANHASSET NY 11030 NASSAU 5164652667
339802 UNIVERSITY HOSPITAL OF BROOKLYN ( DOWNSTATE) T C 445 LENOX ROAD BROOKLYN NY 11203 7182701000
339803 NEW YORK‐PRESBYTERIAN HOSPITAL AT COLUMBIA T C 622 WEST 168TH STREET NEW YORK NY 10032 2123052500
339804 NYU HOSPITALS CENTER T C 550 FIRST AVENUE NEW YORK NY 10016 2122638360 339805 ST LUKE'S ROOSEVELT HOSPITAL ‐ ST LUKE'S DIV T C 1111 AMSTERDAM AVENUE NEW YORK NY 10025 2125235700 339806 WESTCHESTER MEDICAL CENTER T C 100 WOODS RD VALHALLA NY 10595 WESTCHESTER 9142857017 339807 MONTEFIORE MEDICAL CENTER T C 111 EAST 210TH STREET BRONX NY 10467 7189205333 339808 STRONG MEMORIAL HOSPITAL T C 601 ELMWOOD AVENUE ROCHESTER NY 14642 MONROE 5852752121 339809 UNIVERSITY HOSPITAL ( STONY BROOK ) T C NICHOLLS ROAD HSC T19040 STONY BROOK NY 11794 SUFFOLK 6314442209 339810 NEW YORK‐PRESBYTERIAN HOSPITAL AT CORNELL T C 525 EAST 68TH STREET NEW YORK NY 10021 2123055551 339811 ALBANY MEDICAL CENTER T C43 NEW SCOTLAND AVENUE ALBANY NY 12208 ALBANY 5182623028 339812 KALEIDA HEALTH ‐ BUFFALO GENERAL MED CTR T C 100 HIGH STREET BUFFALO NY 14203 ERIE 7168591345 339813 MOUNT SINAI HOSPITAL T C1 GUSTAVE LEVY PLACE NEW YORK NY 10029 2122417981 339814 ERIE COUNTY MEDICAL CENTER T C 462 GRIDER STREET BUFFALO NY 14215 ERIE 7168985240
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 147 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 340001 CAROLINAS HEALTHCARE SYSTEM NORTHEAST 920 CHURCH ST N CONCORD NC 28025 CABARRUS 7047833000 340002 MEMORIAL MISSION HOSPITAL AND ASHEVILLE SURGERY 509 BILTMORE AVE ASHEVILLE NC 28801 BUNCOMBE 8282131111 CE 340003 NORTHERN HOSPITAL OF SURRY COUNTY 830 ROCKFORD ST MOUNT AIRY NC 27030 SURRY 3367197000 340004 HIGH POINT REGIONAL HOSPITAL 601 N ELM ST HIGH POINT NC 27261 GUILFORD 3368786000 340008 SCOTLAND MEMORIAL HOSPITAL 500 LAUCHWOOD DR LAURINBURG NC 28352 SCOTLAND 9102917000 340010 WAYNE MEMORIAL HOSPITAL 2700 WAYNE MEMORIAL DR GOLDSBORO NC 27534 WAYNE 9197361110 340013 RUTHERFORD REGIONAL MEDICAL CENTER 288 SOUTH RIDGECREST AVE RUTHERFORDTON NC 28139 RUTHERFORD 8282865000 340014 NOVANT HEALTH FORSYTH MEDICAL CENTER 3333 SILAS CREEK PARKWAY WINSTON‐SALEM NC 27103 FORSYTH 3367185000 340015 NOVANT HEALTH ROWAN MEDICAL CENTER 612 MOCKSVILLE AVE SALISBURY NC 28144 ROWAN 7042105000 340016 HARRIS REGIONAL HOSPITAL 68 HOSPITAL RD SYLVA NC 28779 JACKSON 8285867000 340017 MARGARET R PARDEE MEMORIAL HOSPITAL 800 N JUSTICE ST HENDERSONVILLE NC 28791 HENDERSON 8286961000 340020 CENTRAL CAROLINA HOSPITAL 1135 CARTHAGE ST SANFORD NC 27330 LEE 9197742100 340021 CAROLINAS HEALTHCARE SYSTEM CLEVELAND 201 E GROVER ST SHELBY NC 28150 CLEVELAND 7044873000 340023 PARK RIDGE HEALTH 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 HENDERSON 8286848501 340024 SAMPSON REGIONAL MEDICAL CENTER 607 BEAMAN ST CLINTON NC 28328 SAMPSON 9105928511 340027 LENOIR MEMORIAL HOSPITAL 100 AIRPORT RD KINSTON NC 28501 LENOIR 2525227000 340028 CAPE FEAR VALLEY MEDICAL CENTER 1638 OWEN DRIVE P O BOX 2000 FAYETTEVILLE NC 28302 CUMBERLAND 9106094000 340030 DUKE UNIVERSITY HOSPITAL PO BOX 3814 DUMC ERWIN RD DURHAM NC 27710 DURHAM 9196848111 340032 CAROMONT REGIONAL MEDICAL CENTER 2525 COURT DR GASTONIA NC 28052 GASTON 7048344891 340037 CAROLINAS HEALTHCARE SYSTEM KINGS MOUNTAIN 706 W KING ST KINGS MOUNTAIN NC 28086 CLEVELAND 7047393601 340039 IREDELL MEMORIAL HOSPITAL INC 557 BROOKDALE DR P O BOX 1828 STATESVILLE NC 28677 IREDELL 7048735661 340040 VIDANT MEDICAL CENTER 2100 STANTONSBURG RD GREENVILLE NC 27834 PITT 2528474100 340041 CALDWELL MEMORIAL HOSPITAL 321 MULBERRY ST SW LENOIR NC 28645 CALDWELL 8287575100 340042 ONSLOW MEMORIAL HOSPITAL 317 WESTERN BOULEVARD JACKSONVILLE NC 28540 ONSLOW 9105772345 340047 NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BOULEVARD WINSTON‐SALEM NC 27157 FORSYTH 3367162011 340049 NORTH CAROLINA SPECIALTY HOSPITAL 3916 BEN FRANKLIN BOULEVARD DURHAM NC 27704 DURHAM 9199569300 340050 SOUTHEASTERN REGIONAL MEDICAL CENTER 300 W 27 ST PO BOX 1408 LUMBERTON NC 28359 ROBESON 9106715000 340051 WATAUGA MEDICAL CENTER 336 DEERFIELD ROAD BOONE NC 28607 WATAUGA 8282624100 340053 NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER 200 HAWTHORNE LANE BOX 33549 CHARLOTTE NC 28233 MECKLENBURG 7043844000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 148 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 340055 VALDESE GENERAL HOSPITAL INC 720 MALCOLM BLVD VALDESE NC 28690 BURKE 8288742251 340060 MOREHEAD MEMORIAL HOSPITAL 117 E KINGS HIGHWAY EDEN NC 27288 ROCKINGHAM 3366239711 340061 UNIVERSITY OF NORTH CAROLINA HOSPITAL 101 MANNING DRIVE CHAPEL HILL NC 27514 ORANGE 9199664141 340064 WILKES REGIONAL MEDICAL CENTER 1370 WEST D ST NORTH WILKESBORO NC 28659 WILKES 3366518100 340068 COLUMBUS REGIONAL HEALTHCARE SYSTEM 500 JEFFERSON ST WHITEVILLE NC 28472 COLUMBUS 9106428011 340069 WAKEMED, RALEIGH CAMPUS 3000 NEW BERN AVE RALEIGH NC 27610 WAKE 9193508000 340070 ALAMANCE REGIONAL MEDICAL CENTER 1240 HUFFMAN MILL RD BURLINGTON NC 27216 ALAMANCE 3365387000 340071 BETSY JOHNSON REGIONAL HOSPITAL 800 TILGHMAN DR DUNN NC 28334 HARNETT 9108927161 340073 DUKE HEALTH RALEIGH HOSPITAL 3400 WAKE FOREST RD RALEIGH NC 27609 WAKE 9199543000 340075 CAROLINAS HEALTHCARE SYSTEM‐BLUE RIDGE 2201 S STERLING ST MORGANTON NC 28655 BURKE 8285805000 340084 CAROLINAS HEALTH CARE SYSTEM ANSON 2301 US HIGHWAY 74 WEST WADESBORO NC 28170 ANSON 7046945131 340085 NOVANT HEALTH THOMASVILLE MEDICAL CENTER 207 OLD LEXINGTON RD BOX 789 THOMASVILLE NC 27360 DAVIDSON 3364722000 340087 THE MCDOWELL HOSPITAL 430 RANKIN DRIVE P O BOX 730 MARION NC 28752 MCDOWELL 8286595000 340090 JOHNSTON HEALTH 509 BRIGHT LEAF BLVD SMITHFIELD NC 27577 JOHNSTON 9199348171 340091 MOSES H CONE MEMORIAL HOSPITAL, THE 1200 N ELM ST GREENSBORO NC 27401 GUILFORD 3368327000 340096 LEXINGTON MEMORIAL HOSPITAL INC 250 HOSPITAL DRIVE PO BOX 1817 LEXINGTON NC 27293 DAVIDSON 3362485161 340097 HUGH CHATHAM MEMORIAL HOSPITAL 180 PARKWOOD DR ELKIN NC 28621 SURRY 3365277000 340098 CAROLINAS HEALTHCARE SYSTEM PINEVILLE 10628 PARK RD CHARLOTTE NC 28210 MECKLENBURG 7043795000 340099 VIDANT ROANOKE CHOWAN HOSPITAL 500 S ACADEMY ST AHOSKIE NC 27910 HERTFORD 2522093000 340106 SANDHILLS REGIONAL MEDICAL CENTER 1000 WEST HAMLET AVENUE HAMLET NC 28345 RICHMOND 9109582361 340107 VIDANT EDGECOMBE HOSPITAL 111 HOSPITAL DR TARBORO NC 27886 EDGECOMBE 2526417700 340109 SENTARA ALBEMARLE MEDICAL CENTER 1144 N ROAD ST ELIZABETH CITY NC 27909 PASQUOTANK 2523350531 340113 CAROLINAS MEDICAL CENTER/BEHAV HEALTH 1000 BLYTHE BLVD CHARLOTTE NC 28203 MECKLENBURG 7043552000 340114 REX HOSPITAL 4420 LAKE BOONE TRAIL RALEIGH NC 27607 WAKE 9197843100 340115 FIRSTHEALTH MOORE REGIONAL HOSPITAL 155 MEMORIAL DRIVE PINEHURST NC 28374 MOORE 9107151000 340116 FRYE REGIONAL MEDICAL CENTER 420 N CENTER ST HICKORY NC 28601 CATAWBA 8283226070 340119 CAROLINAS HEALTHCARE SYSTEM STANLY 301 YADKIN ST ALBEMARLE NC 28001 STANLY 7049844000 340120 VIDANT DUPLIN HOSPITAL 401 N MAIN ST KENANSVILLE NC 28349 DUPLIN 9102960941 340123 RANDOLPH HOSPITAL 364 WHITE OAK STREET ASHEBORO NC 27204 RANDOLPH 3366255151 340126 WILSON MEDICAL CENTER 1705 S TARBORO ST WILSON NC 27893 WILSON 2523998040
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 149 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 340127 GRANVILLE HEALTH SYSTEMS COLLEGE ST BOX 947 OXFORD NC 27565 GRANVILLE 9196903000 340129 LAKE NORMAN REGIONAL MEDICAL CENTER 171 FAIRVIEW ROAD MOORESVILLE NC 28117 IREDELL 7046604000 34012F DURHAM VA MEDICAL CENTER 508 FULTON STREET DURHAM NC 27705 DURHAM 9192860411 340130 CAROLINAS HEALTHCARE SYSTEM UNION 600 HOSPITAL DR MONROE NC 28110 UNION 7042833100 340131 CAROLINA EAST MEDICAL CENTER 2000 NEUSE BLVD NEW BERN NC 28560 CRAVEN 2526338640 340132 MARIA PARHAM MEDICAL CENTER PO BOX 59 HENDERSON NC 27536 VANCE 2524313708 340133 MARTIN GENERAL HOSPITAL 310 S MCCASKEY RD P O BOX 1128 WILLIAMSTON NC 27892 MARTIN 2528096179 340138 CENTRAL REGIONAL HOSPITAL 300 VEAZEY ROAD BUTNER NC 27509 GRANVILLE 9197335540 34013F FAYETTEVILLE VA MEDICAL CENTER 2300 RAMSEY STREET EAST FAYETTEVILLE NC 28301 CUMBERLAND 9104882120 340141 NEW HANOVER REGIONAL MEDICAL CENTER 2131 S 17TH ST BOX 9000 WILMINGTON NC 28402 NEW HANOVER 9103437000 340142 CARTERET GENERAL HOSPITAL 3500 ARENDELL ST MOREHEAD CITY NC 28557 CARTERET 2528086000 340143 CATAWBA VALLEY MEDICAL CENTER 810 FAIRGROVE CHURCH RD HICKORY NC 28602 CATAWBA 8283263809 340144 DAVIS REGIONAL MEDICAL CENTER 218 OLD MOCKSBVILLE RD PO BOX 1823 STATESVILLE NC 28687 IREDELL 7048730281 340145 CAROLINAS HEALTHCARE SYSTEM LINCOLN 433 MCALISTER RD LINCOLNTON NC 28092 LINCOLN 9802122000 340147 NASH GENERAL HOSPITAL 2460 CURTIS ELLIS DRIVE ROCKY MOUNT NC 27804 NASH 2524438000 340148 NOVANT HEALTH MEDICAL PARK HOSPITAL 1950 S HAWTHORNE RD WINSTON‐SALEM NC 27103 FORSYTH 3367180600 340151 HALIFAX REGIONAL MEDICAL CENTER INC 250 SMITH CHURCH RD ROANOKE RAPIDS NC 27870 HALIFAX 2525358005 340155 DUKE REGIONAL HOSPITAL 3643 N ROXBORO ROAD DURHAM NC 27704 DURHAM 9196201078 340156 CHEROKEE INDIAN HOSPITAL AUTHORITY CALLER BOX C268 CHEROKEE NC 28719 SWAIN 7044979163 340158 NOVANT HEALTH BRUNSWICK MEDICAL CENTER 1 MEDICAL CENTER DR PO BOX 139 SUPPLY NC 28462 BRUNSWICK 9107558121 340159 PERSON MEMORIAL HOSPITAL 615 RIDGE RD ROXBORO NC 27573 PERSON 3365992121 340166 CAROLINAS MED CTR‐UNIVERSITY 8800 NORTH TYRON STREET CHARLOTTE NC 28262 MECKLENBURG 7045486000 340168 WILMINGTON TREATMENT CENTER 2520 TROY DRIVE WILMINGTON NC 28401 NEW HANOVER 9197622727 340171 NOVANT HEALTH MATTHEWS MEDICAL CENTER 1500 MATTHEWS TWNSHP PRKWY BOX 3310 MATTHEWS NC 28106 MECKLENBURG 7043846500 340173 WAKEMED, CARY HOSPITAL 1900 KILDARE FARM ROAD CARY NC 27518 WAKE 9193502550 34017F W G HEFNER VA MEDICAL CENTER 1601 BRENNER AVENUE SALISBURY NC 28144 ROWAN 7046389000 340183 NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER 10030 GILEAD ROAD HUNTERSVILLE NC 28078 MECKLENBURG 7043164000 340184 HAYWOOD REGIONAL MEDICAL CENTER 262 LEROY GEORGE DRIVE CLYDE NC 28721 HAYWOOD 8284567311 340186 VIDANT BEAUFORT HOSPITAL 628 E 12TH ST WASHINGTON NC 27889 BEAUFORT 2529754100 340187 DAVIE MEDICAL CENTER 223 HOSPITAL STREET MOCKSVILLE NC 27028 DAVIE 3367518100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 150 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 340188 CAPE FEAR VALLEY HOKE HOSPITAL 210 MEDICAL PAVILION DRIVE RAEFORD NC 28376 HOKE 9100000000 340189 CAROLINAS CONTINUECARE HOSPITAL AT UNIVERSITY 8800 NORTH TRYON ST 4TH FLOOR CHARLOTTE NC 28217 MECKLENBURG 7040000000
34036F ASHEVILLE VA MEDICAL CENTER 1100 TUNNEL ROAD ASHEVILLE NC 28805 BUNCOMBE 8282987911 341302 OUR COMMUNITY HOSPITAL 921 JUNIOR HIGH ROAD SCOTLAND NECK NC 27874 HALIFAX 2528264144 341303 FIRSTHEALTH MONTGOMERY MEMORIAL HOSP 520 ALLEN STREET TROY NC 27371 MONTGOMERY 9105721301 341304 VIDANT BERTIE HOSPITAL 1403 SOUTH KINGS STREET WINDSOR NC 27983 BERTIE 2527946600 341305 SWAIN COUNTY HOSPITAL 45 PLATEAU STREET BRYSON CITY NC 28713 SWAIN 8284882155 341307 PENDER MEMORIAL HOSPITAL 507 E FREMONT ST BURGAW NC 28425 PENDER 9102595451 341311 CHATHAM HOSPITAL INC 475 PROGRESS BLVD SILER CITY NC 27344 CHATHAM 9196632113 341314 WASHINGTON COUNTY HOSP INC 958 US HWY 64 EAST PLYMOUTH NC 27962 WASHINGTON 2527934135 341315 CAPE FEAR VALLEY‐BLADEN COUNTY HOSPITAL 501 SOUTH POPLAR STREET ELIZABETHTOWN NC 28337 BLADEN 9108625100 341316 HIGHLANDS CASHIERS HOSPITAL INC 190 HOSPITAL DRIVE HIGHLANDS NC 28741 MACON 8285261200 341317 PIONEER COMMUNITY HOSPITAL OF STOKES 1570 NC 8 & 89 HWY NORTH DANBURY NC 27016 STOKES 3365932831 341318 VIDANT CHOWAN HOSPITAL 211 VIRGINIA RD EDENTON NC 27932 CHOWAN 2524828451 341319 TRANSYLVANIA REGIONAL HOSPITAL, INC 90 HOSPITAL DRIVE PO BOX 1116 BREVARD NC 28712 TRANSYLVANIA 8288835302 341320 ALLEGHANY COUNTY MEMORIAL HOSPITAL 617 DOCTORS STREET SPARTA NC 28675 ALLEGHANY 3363725511 341322 ST LUKES HOSPITAL 101 HOSPITAL DRIVE COLUMBUS NC 28722 POLK 8288943311 341323 CHARLES A CANNON JR MEMORIAL HOSPITAL 434 HOSPITAL DRIVE LINVILLE NC 28646 AVERY 8287377000 341324 THE OUTER BANKS HOSPITAL, INC 4800 SOUTH CROATAN HIGHWAY NAGS HEAD NC 27959 DARE 2524494500 341325 ASHE MEMORIAL HOSPITAL 200 HOSPITAL AVE JEFFERSON NC 28640 ASHE 3362467101 341326 ANGEL MEDICAL CENTER 120 RIVERVIEW ST PO BOX 1209 FRANKLIN NC 28734 MACON 8285248411 341327 J ARTHUR DOSHER MEMORIAL HOSPITAL 924 HOWE ST SOUTHPORT NC 28461 BRUNSWICK 9104573800 341328 MURPHY MEDICAL CENTER INC 3990 EAST US HIGHWAY 64 ALT MURPHY NC 28906 CHEROKEE 8288378161 341329 BLUE RIDGE REGIONAL HOSPITAL, INC 125 HOSPITAL DR SPRUCE PINE NC 28777 MITCHELL 8287654201 342012 KINDRED HOSPITAL GREENSBORO 2401 SOUTHSIDE BLVD GREENSBORO NC 27406 GUILFORD 3362712800 342013 LIFECARE HOSPITALS OF NC 1031 NOELL LANE ROCKY MOUNT NC 27804 NASH 2524512300 342014 HIGHSMITH RAINEY MEMORIAL HOSPITAL 150 ROBESON STREET 4TH FLOOR FAYETTEVILLE NC 28301 CUMBERLAND 9106096700 342015 CAROLINAS CONTINUECARE HOSPITAL AT PINEVILLE 10648 PARK RD, 3RD FL CHARLOTTE NC 28210 MECKLENBURG 7043795117 342016 SELECT SPECIALTY HOSPITAL‐WINSTON SALEM 3333 SILAS CREEK PARKWAY 6TH FLR WINSTON SALEM NC 27103 FORSYTH 9012776970
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 151 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 342017 ASHEVILLE SPECIALTY HOSPITAL 428 BILTMORE AVENUE 4TH FLOOR ASHEVILLE NC 28802 BUNCOMBE 8282131127 342018 SELECT SPECIALTY HOSPITAL DURHAM INC 3643 NORTH ROXBORO ROAD 6TH FLOOR DURHAM NC 27704 DURHAM 9194709010 342019 CAROLINAS CONTINUECARE AT KINGS MOUNTAIN 706 WEST KING STREET 2ND FLOOR KINGS MOUNTAIN NC 28086 GASTON 7044349466 342020 SELECT SPECIALTY HOSPITAL‐GREENSBORO 1200 NORTH ELM STREET, 5TH FLOOR GREENSBORO NC 27401 GUILFORD 3368327000 343025 CAREPARTNERS REHABILITATION HOSP 68 SWEETEN CREEK RD ASHEVILLE NC 28813 BUNCOMBE 8282742400 343026 CAROLINAS REHABILITATION 1100 BLYTHE BOULEVARD CHARLOTTE NC 28203 MECKLENBURG 7043554370 344001 DOROTHEA DIX HOSPITAL 820 SOUTH BOYLAN AVE RALEIGH NC 27603 WAKE 9197335324 344004 CENTRAL REGIONAL HOSPITAL 300 VEAZY RD BUTNER NC 27509 GRANVILLE 9197642000 344007 OLD VINEYARD YOUTH SERVICES 3637 OLD VINEYARD ROAD WINSTON SALEM NC 27104 FORSYTH 3367943550 344014 HOLLY HILL MENTAL HEALTH SERVICES 3019 FALSTAFF RD RALEIGH NC 27610 WAKE 9192507000 344016 BRYNN MARR HOSP 192 VILLAGE DRIVE JACKSONVILLE NC 28540 ONSLOW 9195771400 344023 JULIAN F KEITH ALCOHOL & DRUG ABUSE TX 201 TABERNACLE ROAD BLACK MOUNTAIN NC 28711 BUNCOMBE 8286693402 344025 BROUGHTON HOSPITAL 1000 S STERLING STREET MORGANTON NC 28655 BURKE 8284332111 344026 CHERRY HOSPITAL 201 STEVENS MILLS RD GOLDSBORO NC 27530 WAYNE 9197313203 344027 RJ BLACKLEY ALCOHOL AND DRUG ABUSE TREATMENT CTR BLDG 29, 30 BARRETT BLDG, 100 H STREET BUTNER NC 27509 GRANVILLE 9195757240
344028 STRATEGIC BEHAVORIAL CENTER‐GARNER 3200 WATERFIELD DRIVE GARNER NC 27529 JOHNSTON 9198004400 344029 GOOD HOPE HOSPITAL, INC 410 DENIM DRIVE ERWIN NC 28339 HARNETT 9102304011 344030 STRATEGIC BEHAVIORAL CENTER‐LELAND 2050 MERCANTILE DRIVE LELAND NC 28451 BRUNSWICK 9013712500 344031 STRATEGIC BEHAVIORAL CENTER‐CHARLOTTE 1715 SHARON ROAD WEST CHARLOTTE NC 28210 MECKLENBURG 7049440650 349800 UNIVERSITY OF NORTH CAROLINA HOSPITALS 101 MANNING DRIVE CHAPEL HILL NC 27514 ORANGE 9199661645 349801 PITT COUNTY MEMORIAL HOSPITAL 2100 STANTONSBURG ROAD, PO BOX 6028 GREENVILLE NC 27835 PITT 2528474398 349802 CAROLINAS MEDICAL CENTER TRANSPLANT CENTER, PO BOX 32861 CHARLOTTE NC 28232 MECKLENBURG 7043556649 349803 WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER MEDICAL CENTER BOULEVARD WINSTON SALEM NC 27157 FORSYTH 3367135623 349804 DUKE UNIVERSITY HOSPTIAL PO BOX 3876, DUKE UNIVERSITY MEDICAL CENTER DURHAM NC 27710 DURHAM 9196845926 350002 ST ALEXIUS MEDICAL CENTER 900 E BROADWAY BISMARCK ND 58501 BURLEIGH 7015307000 350006 TRINITY HOSPITALS 407 3RD ST SE MINOT ND 58701 WARD 7018575000 350011 SANFORD MEDICAL CENTER FARGO 801 BROADWAY NORTH FARGO ND 58122 CASS 7012342000 350015 SANFORD MEDICAL CENTER BISMARCK 300 N 7TH ST BISMARCK ND 58506 BURLEIGH 7013236000 350019 ALTRU HOSPITAL 1200 S COLUMBIA RD GRAND FORKS ND 58201 GRAND FORKS 7017805000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 152 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 35002F VA HOSP ELM ST + 21ST AVE N FARGO ND 58102 CASS 35003F US AIR FORCE HOSP 9TH AVE + NW 12TH ST MINOT ND 58701 WARD 350063 P H S INDIAN HOSP AT BELCOURT‐QUENTIN N BURDICK PO BOX 160 BELCOURT ND 58316 ROLETTE 7014776111
350064 STANDING ROCK INDIAN HEALTH SERVICE HOSPITAL 10 NORTH RIVER ROAD FORT YATES ND 58538 SIOUX 7018543831 350070 ESSENTIA HEALTH‐FARGO 3000 32ND AVE SOUTH FARGO ND 58104 CASS 7013648000 351300 TIOGA MEDICAL CENTER 810 N WELO ST TIOGA ND 58852 WILLIAMS 7016643305 351301 MOUNTRAIL COUNTY MEDICAL CENTER 615 6TH ST SE STANLEY ND 58784 MOUNTRAIL 7016282424 351302 MCKENZIE COUNTY HEALTHCARE SYSTEMS 516 NORTH MAIN ST WATFORD CITY ND 58854 MCKENZIE 7018423000 351303 GARRISON MEMORIAL HOSPITAL 407 3RD AVE SE GARRISON ND 58540 MCLEAN 7014632275 351304 COMMUNITY MEMORIAL HOSPITAL 220 5TH AVE WTURTLE LAKE ND 58575 MCLEAN 7014482331 351305 KENMARE COMMUNITY HOSPITAL PO BOX 697 KENMARE ND 58746 WARD 7013854296 351306 COOPERSTOWN MEDICAL CENTER 1200 ROBERTS AVE NE COOPERSTOWN ND 58425 GRIGGS 7017972221 351307 ST ANDREWS HEALTH CENTER ‐ CAH 316 OHMER STREET BOTTINEAU ND 58318 BOTTINEAU 7012289300 351308 NELSON COUNTY HEALTH SYSTEM 200 N MAIN ST MCVILLE ND 58254 NELSON 7013224328 351309 SANFORD MAYVILLE 42 6TH AVENUE SE MAYVILLE ND 58257 TRAILL 7017863800 351310 SAKAKAWEA MEDICAL CENTER ‐ CAH 510 8TH AVENUE NE HAZEN ND 58545 MERCER 7017482225 351311 LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON ND 58054 RANSOM 7016835241 351312 NORTHWOOD DEACONESS HEALTH CENTER PO BOX 190 NORTHWOOD ND 58267 GRAND FORKS 7015876060 351313 SOUTHWEST HEALTHCARE SERVICES 14 6TH AVE SW BOWMAN ND 58623 BOWMAN 7015235265 351314 JACOBSON MEMORIAL HOSPITAL CARE CENTER 601 EAST ST N ELGIN ND 58533 GRANT 7015842792 351315 OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES ND 58474 DICKEY 7017423291 351316 PRESENTATION MEDICAL CENTER 213 SECOND AVE NE ROLLA ND 58367 ROLETTE 7014773161 351318 CARRINGTON HEALTH CENTER PO BOX 461 CARRINGTON ND 58421 FOSTER 7016523141 351319 PEMBINA COUNTY MEMORIAL HOSPITAL BOX 380 CAVALIER ND 58220 PEMBINA 7012658461 351320 UNITY MEDICAL CENTER 164 W 13TH STREET GRAFTON ND 58237 WALSH 7013521620 351321 WISHEK COMMUNITY HOSPITAL 1007 4TH AVE S WISHEK ND 58495 MCINTOSH 7014522326 351322 ASHLEY MEDICAL CENTER 612 CENTER AVENUE N ASHLEY ND 58413 MCINTOSH 7012883433 351323 CAVALIER COUNTY MEMORIAL HOSPITAL 909 2ND ST LANGDON ND 58249 CAVALIER 7012566100 351324 MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 BARNES 7018456400
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 153 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 351325 ST LUKE'S HOSPITAL 702 1ST ST SW CROSBY ND 58730 DIVIDE 7019656384 351326 FIRST CARE HEALTH CENTER 115 VIVIAN ST PARK RIVER ND 58270 WALSH 7012847500 351327 ST ALOISIUS MEDICAL CENTER 325 E BREWSTER ST HARVEY ND 58341 WELLS 7013244651 351328 LINTON HOSPITAL ‐ CAH 518 NORTH BROADWAY LINTON ND 58552 EMMONS 7012544511 351329 SANFORD HILLSBORO 12 THIRD STREET SOUTH EAST HILLSBORO ND 58045 TRAILL 7016363200 351330 WEST RIVER REGIONAL MEDICAL CENTER‐CAH 1000 HIGHWAY 12 HETTINGER ND 58639 ADAMS 7015674561 351331 TOWNER COUNTY MEDICAL CENTER HWY 281 N CANDO ND 58324 TOWNER 7019684411 351332 HEART OF AMERICA MEDICAL CENTER 800 S MAIN AVE RUGBY ND 58368 PIERCE 7017765261 351333 CHI ST ALEXIUS HEALTH DEVILS LAKE 1031 7TH ST NE DEVILS LAKE ND 58301 RAMSEY 7016622131 351334 CHI ST ALEXIUS HEALTH WILLISTON 1301 15TH AVE W WILLISTON ND 58801 WILLIAMS 7017747400 351335 JAMESTOWN REGIONAL MEDICAL CENTER 2422 20TH ST SW JAMESTOWN ND 58401 STUTSMAN 7012521050 351336 CHI ST ALEXIUS HEALTH DICKINSON 2500 FAIRWAY STREET DICKINSON ND 58601 STARK 7014564000 352004 VIBRA HOSPITAL OF FARGO 1720 UNIVERSITY DRIVE SOUTH FARGO ND 58103 CASS 7012419099 352005 VIBRA HOSPITAL OF CENTRAL DAKOTAS 1000 18TH STREET NW MANDAN ND 58554 MORTON 7016672000 354003 NORTH DAKOTA STATE HOSPITAL 2605 CIRCLE DRIVE JAMESTOWN ND 58401 STUTSMAN 7012533650 354004 PRAIRIE ST JOHNS 510 4TH STREET SOUTH FARGO ND 58103 CASS 7014767200 354005 RICHARD P STADTER PSYCHIATRIC CENTER 1451 44TH AVENUE SGRAND FORKS ND 58208 GRAND FORKS 7017722500 359810 SANFORD BISMARCK TRANSPLANT CENTER 300 N 7TH ST BISMARCK ND 58501 BURLEIGH 7013232828 359811 SANFORD TRANSPLANT CENTER 736 BROADWAY FARGO ND 58122 CASS 7012342411 360001 MERCY HOSPITAL ANDERSON 7500 STATE ROAD CINCINNATI OH 45255 HAMILTON 5136244006 360002 SAMARITAN REGIONAL HEALTH SYSTEM 1025 CENTER ST ASHLAND OH 44805 ASHLAND 4192890491 360003 UNIVERSITY OF CINCINNATI MEDICAL CENTER, LLC 234 GOODMAN STREET CINCINNATI OH 45219 HAMILTON 5135841000 360006 RIVERSIDE METHODIST HOSPITAL 3535 OLENTANGY RIVER RD COLUMBUS OH 43214 FRANKLIN 6145665000 360008 SOUTHERN OHIO MEDICAL CENTER 1805 27TH STREET PORTSMOUTH OH 45662 SCIOTO 7403565000 360009 LIMA MEMORIAL HEALTH SYSTEM 1001 BELLEFONTAINE AVENUE LIMA OH 45804 ALLEN 4199984731 360010 UNION HOSPITAL 659 BOULEVARD DOVER OH 44622 TUSCARAWAS 3303433311 360011 MARION GENERAL HOSPITAL 1000 MCKINLEY PARK DRIVE MARION OH 43302 MARION 7403838400 360012 MOUNT CARMEL ST ANN'S 500 SOUTH CLEVELAND AVENUE WESTERVILLE OH 43081 FRANKLIN 6148984000 360013 WILSON MEMORIAL HOSPITAL 915 WEST MICHIGAN STREET SIDNEY OH 45365 SHELBY 9374985418 360014 OHIOHEALTH O'BLENESS HOSPITAL 55 HOSPITAL DRIVE ATHENS OH 45701 ATHENS 7405929233
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 154 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 360016 JEWISH HOSPITAL, LLC 4777 EAST GALBRAITH ROAD CINCINNATI OH 45236 HAMILTON 5136863000 360017 GRANT MEDICAL CENTER 111 SOUTH GRANT AVENUE COLUMBUS OH 43215 FRANKLIN 6145669978 360019 SUMMA BARBERTON HOSPITAL 155 5TH STREET N E BARBERTON OH 44203 SUMMIT 3306153000 36001F LOUIS STOKES VA MEDICAL CENTER‐WADE PARK DIVISION 10701 EAST BOULEVARD CLEVELAND OH 44106 CUYAHOGA 2167913800
360020 SUMMA HEALTH SYSTEM 525 EAST MARKET STREET AKRON OH 44309 SUMMIT 3303753000 360025 FIRELANDS REGIONAL MEDICAL CENTER 1111 HAYES AVENUE SANDUSKY OH 44870 ERIE 4195577400 360026 GREENE MEMORIAL HOSPITAL 1141 NORTH MONROE DRIVE XENIA OH 45385 GREENE 9373522000 360027 AKRON GENERAL MEDICAL CENTER 400 WABASH AVENUE AKRON OH 44307 SUMMIT 3303446000 360029 WOOD COUNTY HOSPITAL 950 WEST WOOSTER STREET BOWLING GREEN OH 43402 WOOD 4193548900 36002F FEDERAL REFORMATORY HOSP CHILLICOTHE OH 45601 ROSS 360032 GRAND LAKE HEALTH SYSTEM 200 SAINT CLAIR STREET SAINT MARYS OH 45885 AUGLAIZE 4193943335 360035 MOUNT CARMEL WEST 793 WEST STATE STREET COLUMBUS OH 43222 FRANKLIN 6142345000 360036 WOOSTER COMMUNITY HOSPITAL 1761 BEALL AVENUE WOOSTER OH 44691 WAYNE 3302638100 360037 ST VINCENT CHARITY MEDICAL CENTER 2351 EAST 22ND STREET CLEVELAND OH 44115 CUYAHOGA 2168616200 360039 GENESIS HOSPITAL 2951 MAPLE AVENUE ZANESVILLE OH 43701 MUSKINGUM 7404545000 36003F VA HOSP 3200 VINE ST CINCINNATI OH 45220 HAMILTON 8001234560 360040 KNOX COMMUNITY HOSPITAL 1330 COSHOCTON ROAD MOUNT VERNON OH 43050 KNOX 7403939000 360041 PARMA COMMUNITY GENERAL HOSPITAL 7007 POWERS BOULEVARD PARMA OH 44129 CUYAHOGA 4407433000 360044 WAYNE HOSPITAL 835 SWEITZER STREET GREENVILLE OH 45331 DARKE 9375475722 360046 MCCULLOUGH‐HYDE MEMORIAL HOSPITAL 110 NORTH POPLAR STREET OXFORD OH 45056 BUTLER 5135232111 360047 PIKE COUNTY HOSPITAL DAWN LANE WAVERLY OH 45690 PIKE 6149472186 360048 UNIVERSITY OF TOLEDO MEDICAL CENTER 3000 ARLINGTON AVENUE TOLEDO OH 43699 LUCAS 4193833407 36004F VA HOSP 7300 YORK RD CLEVELAND OH 44106 CUYAHOGA 8001234567 360051 MIAMI VALLEY HOSPITAL ONE WYOMING STREET DAYTON OH 45409 MONTGOMERY 9372088000 360052 GOOD SAMARITAN HOSPITAL 2222 PHILADELPHIA DRIVE DAYTON OH 45406 MONTGOMERY 9372782612 360054 HOLZER MEDICAL CENTER 100 JACKSON PIKE GALLIPOLIS OH 45631 GALLIA 7404465000 360055 TRUMBULL MEMORIAL HOSPITAL 1350 EAST MARKET STREET WARREN OH 44482 TRUMBULL 3308419011 360056 MERCY HOSPITAL FAIRFIELD 3000 MACK ROAD FAIRFIELD OH 45014 BUTLER 5138707197 360058 MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL 800 WEST MAIN STREET COLDWATER OH 45828 MERCER 4196784843
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 155 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 360059 METROHEALTH SYSTEM 2500 METROHEALTH DRIVE CLEVELAND OH 44109 CUYAHOGA 2167787089 36005F US AIR FORCE HOSP LOCKBOURNE AFB COLUMBUS OH 43217 FRANKLIN 360064 ST ELIZABETH YOUNGSTOWN HOSPITAL 1044 BELMONT AVENUE YOUNGSTOWN OH 44501 MAHONING 3307467211 360065 FISHER‐TITUS HOSPITAL 272 BENEDICT AVENUE NORWALK OH 44857 HURON 4196688101 360066 ST RITA'S MEDICAL CENTER 730 WEST MARKET STREET LIMA OH 45801 ALLEN 4192273361 360068 TOLEDO HOSPITAL THE 2142 NORTH COVE BOULEVARD TOLEDO OH 43606 LUCAS 4192917463 36006F US AIR FORCE HOSP WRIGHT‐PATTERSON AFB DAYTON OH 45433 GREENE 360070 MERCY MEDICAL CENTER 1320 MERCY DRIVE NW CANTON OH 44708 STARK 3304891001 360071 VAN WERT COUNTY HOSPITAL 1250 S WASHINGTON STREET VAN WERT OH 45891 VAN WERT 4192388627 360072 FAIRFIELD MEDICAL CENTER 401 NORTH EWING STREET LANCASTER OH 43130 FAIRFIELD 7406878009 360074 FLOWER HOSPITAL 5200 HARROUN ROAD SYLVANIA OH 43560 LUCAS 4198241444 360075 UHHS RICHMOND HEIGHTS HOSPITAL 27100 CHARDON ROAD RICHMOND HEIGHTS OH 44143 CUYAHOGA 4405856170 360076 ATRIUM MEDICAL CENTER ONE MEDICAL CENTER DRIVE FRANKLIN OH 45005 WARREN 5134205102 360077 FAIRVIEW HOSPITAL 18101 LORAIN AVENUE CLEVELAND OH 44111 CUYAHOGA 2164767000 360078 UNIVERSITY HOSPITALS PORTAGE MEDICAL CENTER 6847 N CHESTNUT RAVENNA OH 44266 PORTAGE 3302972300 360079 KETTERING MEDICAL CENTER 3535 SOUTHERN BOULEVARD KETTERING OH 45429 MONTGOMERY 9372984331 36007F DAYTON VA MEDICAL CENTER 4100 W 3RD ST DAYTON OH 45428 MONTGOMERY 9372686511 360080 EAST OHIO REGIONAL HOSPITAL 90 NORTH FOURTH STREET MARTINS FERRY OH 43935 BELMONT 7406334151 360081 MERCY ST CHARLES HOSPITAL 2600 NAVARRE AVENUE OREGON OH 43616 LUCAS 4196967200 360082 EUCLID HOSPITAL 18901 LAKE SHORE BOULEVARD EUCLID OH 44119 CUYAHOGA 2165319000 360084 AULTMAN HOSPITAL 2600 SIXTH STREET SW CANTON OH 44710 STARK 3304529911 360085 OHIO STATE UNIVERSITY HOSPITALS 410 WEST 10TH AVENUE COLUMBUS OH 43210 FRANKLIN 6142939700 360086 SPRINGFIELD REGIONAL MEDICAL CENTER 100 MEDICAL CENTER DRIVE SPRINGFIELD OH 45504 CLARK 9375231000 360087 LUTHERAN HOSPITAL 1730 WEST 25TH STREET CLEVELAND OH 44113 CUYAHOGA 2166964300 360089 MERCY TIFFIN HOSPITAL 45 ST LAWRENCE DRIVE TIFFIN OH 44883 SENECA 4194557000 36008F CHILLICOTHE VA MEDICAL CENTER 17273 STATE ROUT 104 CHILLICOTHE OH 45601 ROSS 7407731141 360090 ST LUKE'S HOSPITAL 5901 MONCLOVA ROAD MAUMEE OH 43537 LUCAS 4198935900 360091 MEDINA HOSPITAL 1000 EAST WASHINGTON STREET MEDINA OH 44256 MEDINA 3307251000 360092 MEMORIAL HOSPITAL 500 LONDON AVENUE MARYSVILLE OH 43040 UNION 9375782289 360095 BLANCHARD VALLEY HOSPITAL 1900 SOUTH MAIN STREET FINDLAY OH 45840 HANCOCK 4194234500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 156 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 360096 EAST LIVERPOOL CITY HOSPITAL 425 WEST 5TH STREET EAST LIVERPOOL OH 43920 COLUMBIANA 3303857200 360098 LAKE HEALTH 7590 AUBURN ROAD CONCORD OH 44077 LAKE 4409539600 36009F CHALMERS P WYLIE OUTPATIENT CLINIC 543 TAYLOR AVENUE COLUMBUS OH 43203 FRANKLIN 6142575263 360107 BELLEVUE HOSPITAL 1400 WEST MAIN STREET BELLEVUE OH 44811 SANDUSKY 4194834040 360109 COSHOCTON COUNTY MEMORIAL HOSPITAL 1460 ORANGE STREET COSHOCTON OH 43812 COSHOCTON 7406226411 36010E HYGEIA HALL INFIRMARY WOOSTER OH 44691 WAYNE 360112 MERCY ST VINCENT MEDICAL CENTER 2213 CHERRY STREET TOLEDO OH 43608 LUCAS 4192513232 360118 OHIOHEALTH MANSFIELD HOSPITAL 335 GLESSNER AVENUE MANSFIELD OH 44903 RICHLAND 4195268000 360121 COMMUNITY HOSPITALS AND WELLNESS CENTERS 433 WEST HIGH STREET BRYAN OH 43506 WILLIAMS 4196361131 360123 ST JOHN MEDICAL CENTER 29000 CENTER RIDGE ROAD WESTLAKE OH 44145 CUYAHOGA 4408358000 360125 ASHTABULA COUNTY MEDICAL CENTER 2420 LAKE AVENUE ASHTABULA OH 44004 ASHTABULA 4409972262 36012E DENISON UNIVERSITY INFIRMARY GRANVILLE OH 43023 LICKING 360131 ALLIANCE COMMUNITY HOSPITAL 200 EAST STATE STREET ALLIANCE OH 44601 STARK 3305967527 360132 FORT HAMILTON HUGHES MEMORIAL HOSPITAL 630 EATON AVENUE HAMILTON OH 45013 BUTLER 5138672000 360133 GRANDVIEW HOSPITAL & MEDICAL CENTER 405 GRAND AVENUE DAYTON OH 45405 MONTGOMERY 9377233312 360134 GOOD SAMARITAN HOSPITAL 375 DIXMYTH AVENUE CINCINNATI OH 45220 HAMILTON 5138622601 360137 UH CLEVELAND MEDICAL CENTER 11100 EUCLID AVENUE CLEVELAND OH 44106 CUYAHOGA 2168441000 36013E BOWLING GREEN STATE UNIVERSITY INF BOWLING GREEN OH 43402 WOOD 360141 NORTHSIDE MEDICAL CENTER 500 GYPSY LANE YOUNGSTOWN OH 44501 MAHONING 3308841003 360142 HIGHLAND DISTRICT HOSPITAL 1275 NORTH HIGH STREET HILLSBORO OH 45133 HIGHLAND 9373936100 360143 MARYMOUNT HOSPITAL 12300 MCCRACKEN ROAD GARFIELD HEIGHTS OH 44125 CUYAHOGA 2165810500 360144 SOUTH POINTE HOSPITAL 20000 HARVARD ROAD WARRENSVILLE HEIGHTS OH 44122 CUYAHOGA 2164916000 360145 UNIVERSITY HOSPITALS ‐ ELYRIA MEDICAL CENTER 630 EAST RIVER STREET ELYRIA OH 44035 LORAIN 4403297500 360147 MARIETTA MEMORIAL HOSPITAL 401 MATTHEW STREET MARIETTA OH 45750 WASHINGTON 7403741400 360148 POMERENE HOSPITAL 981 WOOSTER ROAD MILLERSBURG OH 44654 HOLMES 3306741015 36014E MIAMI UNIVERSITY INFIRMARY SPRING ST OXFORD OH 45056 BUTLER 360150 SUMMA WESTERN RESERVE HOSPITAL 1900 23RD STREET CUYAHOGA FALLS OH 44223 SUMMIT 3309717000 360151 AFFINITY MEDICAL CENTER 875 EIGHTH STREET NE MASSILLON OH 44646 STARK 3308376863 360152 DOCTORS HOSPITAL 5100 WEST BROAD STREET COLUMBUS OH 43228 FRANKLIN 6145441000 360153 BELMONT COMMUNITY HOSPITAL 4697 HARRISON STREET BELLAIRE OH 43906 BELMONT 7406711200
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 157 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 360155 SOUTHWEST GENERAL HEALTH CENTER 18697 BAGLEY ROAD MIDDLEBURG HEIGHTS OH 44130 CUYAHOGA 4408168000 360156 MEMORIAL HOSPITAL 715 SOUTH TAFT AVENUE FREMONT OH 43420 SANDUSKY 4193346617 360159 ADENA REGIONAL MEDICAL CENTER 272 HOSPITAL ROAD CHILLICOTHE OH 45601 ROSS 7407797500 36015E DAYTON CHILDRENS HOSP DAYTON OH 45401 MONTGOMERY 360161 ST JOSEPH WARREN HOSPITAL 667 EASTLAND AVE SE WARREN OH 44481 TRUMBULL 3308414000 360163 CHRIST HOSPITAL 2139 AUBURN AVENUE CINCINNATI OH 45219 HAMILTON 5135852000 360170 BERGER HOSPITAL 600 NORTH PICKAWAY STREET CIRCLEVILLE OH 43113 PICKAWAY 7404208585 360172 MERCY REGIONAL MEDICAL CENTER 3700 KOLBE ROAD LORAIN OH 44053 LORAIN 4409604000 360174 UPPER VALLEY MEDICAL CENTER 3130 NORTH COUNTY ROAD 25A TROY OH 45373 MIAMI 9374407853 360175 CLINTON MEMORIAL HOSPITAL 610 WEST MAIN STREET WILMINGTON OH 45177 CLINTON 9373826611 360179 BETHESDA NORTH 10500 MONTGOMERY ROAD CINCINNATI OH 45242 HAMILTON 5138651241 360180 CLEVELAND CLINIC 9500 EUCLID AVENUE CLEVELAND OH 44195 CUYAHOGA 2164442200 360185 SALEM REGIONAL MEDICAL CENTER 1995 EAST STATE STREET SALEM OH 44460 COLUMBIANA 3303321551 360189 MADISON COUNTY HOSPITAL INC 210 NORTH MAIN STREET LONDON OH 43140 MADISON 7408457000 360192 UH GEAUGA MEDICAL CENTER 13207 RAVENNA RD CHARDON OH 44024 GEAUGA 4402696000 360197 MARY RUTAN HOSPITAL 205 PALMER AVENUE BELLEFONTAINE OH 43311 LOGAN 9375924015 360203 SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER 1341 NORTH CLARK STREET CAMBRIDGE OH 43725 GUERNSEY 7404398111 36020E DARTMOUTH HOSP 1038 SALEM AVE DAYTON OH 45406 MONTGOMERY 360210 GRADY MEMORIAL HOSPITAL 561 WEST CENTRAL AVENUE DELAWARE OH 43015 DELAWARE 7403685145 360211 TRINITY MEDICAL CTR EAST &TRINITY MEDICAL CTR WEST 380 SUMMIT AVENUE STEUBENVILLE OH 43952 JEFFERSON 7402837000
360218 LICKING MEMORIAL HOSPITAL 1320 WEST MAIN STREET NEWARK OH 43055 LICKING 7403484000 36021E MASONIC‐RICKLEY MEM HOSP W NATIONAL RD BOX 478 SPRINGFIELD OH 45504 CLARK 360230 HILLCREST HOSPITAL 6780 MAYFIELD ROAD MAYFIELD HEIGHTS OH 44124 CUYAHOGA 4403124500 360234 MERCY HEALTH ‐ WEST HOSPITAL 3300 MERCY HEALTH BLVD CINCINNATI OH 45211 HAMILTON 5132155000 360236 MERCY HOSPITAL CLERMONT 3000 HOSPITAL DRIVE BATAVIA OH 45103 CLERMONT 5137328278 360239 SYCAMORE MEDICAL CENTER 4000 MIAMISBURG‐CENTERVILLE ROAD MIAMISBURG OH 45342 MONTGOMERY 9373848776 36023E NIGHTINGALE COTTAGE HOSP BRICE RD REYNOLDSBURG OH 43068 FRANKLIN 360241 EDWIN SHAW REHAB INSTITUTE 330 BROADWAY EAST CUYAHOGA FALLS OH 44221 SUMMIT 3304360910 360242 JAMES CANCER HOSPITAL & SOLOVE RESEARCH INSTITUTE 460 WEST TENTH AVENUE COLUMBUS OH 43210 FRANKLIN 6142933121
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 158 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 360245 GLENBEIGH HEALTH SOURCES 2863 STATE ROUTE 45 ROCK CREEK OH 44084 ASHTABULA 4405633400 360247 WOODS AT PARKSIDE,THE 349 OLDE RIDENOUR ROAD COLUMBUS OH 43230 FRANKLIN 6144712552 36024E SAGAMORE HILLS HOSP 11910 DUNHAM RD NORTHFIELD OH 44067 SUMMIT 360259 BAY PARK COMMUNITY HOSPITAL 2801 BAY PARK DRIVE OREGON OH 43616 LUCAS 4196907700 36025E MT VERNON STATE HOSP SANATORIUM RD MOUNT VERNON OH 43050 KNOX 360261 THREE GABLES SURGERY CENTER 5897 COUNTY ROAD 107 PROCTORVILLE OH 45669 LAWRENCE 7408869911 360262 MERCY ST ANNE HOSPITAL 3404 SYLVANIA AVENUE TOLEDO OH 43623 LUCAS 4194072663 360263 INSTITUTE FOR ORTHOPAEDIC SURGERY 801 MEDICAL DRIVE, SUITE B LIMA OH 45804 ALLEN 4192247586 360266 MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL 7333 SMITH'S MILL ROAD NEW ALBANY OH 43054 FRANKLIN 6147756600 36026E GOODYEAR TIRE HOSP AKRON OH 44305 SUMMIT 360270 MERCY HOSPITAL OF DEFIANCE 1404 EAST SECOND STREET DEFIANCE OH 43512 DEFIANCE 4197828444 360274 MEDICAL CENTER AT ELIZABETH PLACE ONE ELIZABETH PLACE DAYTON OH 45417 MONTGOMERY 9378531053 360276 ST ELIZABETH BOARDMAN HEALTH CENTER 8401 MARKET STREET BOARDMAN OH 44512 MAHONING 3307292929 36029E WESTERN COLLEGE INFIRMARY HOSP OXFORD OH 45056 BUTLER 36030E MADISON HOSP 73 MADISON RD MANSFIELD OH 44905 RICHLAND 36033E RIDGECLIFF HOSP 28777 RIDGE RD WICKLIFFE OH 44092 LAKE 360347 MEDICAL CENTER OF NEWARK LLC 2000 TAMARACK ROAD NEWARK OH 43055 LICKING 7405227800 360348 DUBLIN METHODIST HOSPITAL 7500 HOSPITAL AVENUE DUBLIN OH 43016 FRANKLIN 6145448000 36034E NORTH CANTON COMM HOSP 932 N MAIN ST NORTH CANTON OH 44720 STARK 360351 CRYSTAL CLINIC ORTHOPAEDIC CENTER 444 NORTH MAIN STREET AKRON OH 44310 SUMMIT 3306684040 360352 SURGICAL HOSPITAL AT SOUTHWOODS 7630 SOUTHERN BLVD YOUNGSTOWN OH 44512 MAHONING 3307581954 360354 WEST CHESTER HOSPITAL, LLC 7700 UNIVERSITY DRIVE WEST CHESTER OH 45069 BUTLER 5132983000 360355 OHIO VALLEY MEDICAL CENTER, LLC 100 WEST MAIN STREET SPRINGFIELD OH 45502 CLARK 9375213900 360358 DILEY RIDGE MEDICAL CENTER 7911 DILEY ROAD CANAL WINCHESTER OH 43110 FAIRFIELD 6148387910 360359 UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER 3999 RICHMOND ROAD BEACHWOOD OH 44122 CUYAHOGA 2165935510 360360 SOIN MEDICAL CENTER 3535 PENTAGON PARK BLVD BEAVER CREEK OH 45431 GREENE 9377024000 360361 KINGS DAUGHTERS MEDICAL CENTER OHIO 1901 ARGONNE ROAD PORTSMOUTH OH 45662 SCIOTO 7409914000 360362 TRIHEALTH EVENDALE HOSPITAL 3155 GLENDALE MILFORD ROAD CINCINNATI OH 45241 HAMILTON 5134542222 36037E LIMA STATE HOSP NORTHWEST ST LIMA OH 45802 ALLEN 36040E GIBBONS HOSP 117 E FAYETTE ST CELINA OH 45822 MERCER
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 159 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 36041E WOODRUFF HOSP 8811 EUCLID CLEVELAND OH 44115 CUYAHOGA 36042F AIRFORCE MEDICAL CTR WRIGHT‐PATTERSON 4881 SUGAR MAPLE DRIVE WRIGHT PATTERSON AFB OH 45433 GREENE 9372570803 361300 PAULDING COUNTY HOSPITAL 1035 WEST WAYNE ST. PAULDING OH 45879 PAULDING 4193994080 361301 COMMUNITY MEMORIAL HOSPITAL 208 N COLUMBUS ST HICKSVILLE OH 43526 DEFIANCE 4195426692 361302 TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON OH 44621 TUSCARAWAS 7409222800 361303 LODI COMMUNITY HOSPITAL 225 ELYRIA STREET LODI OH 44254 MEDINA 3309481222 361304 GREENFIELD AREA MEDICAL CENTER 550 MIRABEAU STREET GREENFIELD OH 45123 HIGHLAND 9379819400 361306 MERCY ALLEN HOSPITAL 200 WEST LORAIN STREET OBERLIN OH 44074 LORAIN 4407751211 361307 UHHS MEMORIAL HOSPITAL OF GENEVA 870 WEST MAIN STREET GENEVA OH 44041 ASHTABULA 4404661141 361308 UNIVERSITY HOSPITALS CONNEAUT MEDICAL CENTER 158 WEST MAIN ROAD CONNEAUT OH 44030 ASHTABULA 4405931131 361309 HENRY COUNTY HOSPITAL, INC 1600 EAST RIVERVIEW AVENUE NAPOLEON OH 43545 HENRY 4195924015 361310 MERCY WILLARD HOSPITAL 1100 NEAL ZICK ROAD WILLARD OH 44890 HURON 4199645000 361311 HARRISON COMMUNITY HOSPITAL 951 EAST MARKET STREET CADIZ OH 43907 HARRISON 7409424631 361312 MERCY MEMORIAL HOSPITAL 904 SCIOTO STREET URBANA OH 43078 CHAMPAIGN 9376535231 361313 MORROW COUNTY HOSPITAL 651 WEST MARION ROAD MOUNT GILEAD OH 43338 MORROW 4199465015 361314 H B MAGRUDER MEMORIAL HOSPITAL 615 FULTON ST PORT CLINTON OH 43452 OTTAWA 4197343131 361315 HARDIN MEMORIAL HOSPITAL 921 EAST FRANKLIN STREET KENTON OH 43326 HARDIN 4196730761 361316 BUCYRUS COMMUNITY HOSPITAL 629 NORTH SANDUSKY AVENUE BUCYRUS OH 44820 CRAWFORD 4195624677 361318 FOSTORIA COMMUNITY HOSPITAL 501 VAN BUREN STREET FOSTORIA OH 44830 SENECA 4194357734 361319 SELBY GENERAL HOSPITAL 1106 COLEGATE DRIVE MARIETTA OH 45750 WASHINGTON 7405682000 361320 HOLZER MEDICAL CENTER JACKSON 500 BURLINGTON ROAD JACKSON OH 45640 JACKSON 7403958500 361321 BARNESVILLE HOSPITAL ASSOCIATION, INC 639 WEST MAIN STREET BARNESVILLE OH 43713 BELMONT 7404255101 361322 BLUFFTON HOSPITAL 139 GARAU STREET BLUFFTON OH 45817 ALLEN 4193589010 361323 AULTMAN ORRVILLE HOSPITAL 832 SOUTH MAIN STREET ORRVILLE OH 44667 WAYNE 3306823010 361324 OHIOHEALTH SHELBY HOSPITAL 199 WEST MAIN STREET SHELBY OH 44875 RICHLAND 4193425015 361325 GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 44833 CRAWFORD 4194684841 361326 ADAMS COUNTY REGIONAL MEDICAL CENTER 230 MEDICAL CENTER DRIVE SEAMAN OH 45679 ADAMS 9373863400 361327 COMMUNITY HOSPITALS AND WELLNESS CENTERS 909 EAST SNYDER AVENUE MONTPELIER OH 43543 WILLIAMS 4194853154 361328 DEFIANCE REGIONAL MEDICAL CENTER 1200 RALSTON AVENUE DEFIANCE OH 43512 DEFIANCE 4197836955 361329 WYANDOT MEMORIAL HOSPITAL 885 NORTH SANDUSKY AVENUE UPPER SANDUSKY OH 43351 WYANDOT 4192944991
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 160 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 361330 HOCKING VALLEY COMMUNITY HOSPITAL 601 STATE ROUTE 664N LOGAN OH 43138 HOCKING 7403808000 361331 FAYETTE COUNTY MEMORIAL HOSPITAL 1430 COLUMBUS AVENUE WASHINGTON CH OH 43160 FAYETTE 7403331210 361332 HIGHLAND DISTRICT HOSPITAL 1275 NORTH HIGH STREET HILLSBORO OH 45133 HIGHLAND 9373936100 361333 FULTON COUNTY HEALTH CENTER 725 SOUTH SHOOP AVENUE WAUSEON OH 43567 FULTON 4193352015 361334 ADENA PIKE MEDICAL CENTER 100 DAWN LANE WAVERLY OH 45690 PIKE 7409472186 361991 GLENMONT 4599 AVERY ROAD HILLIARD OH 43026 FRANKLIN 6148760084 362004 DRAKE CENTER INC 151 WEST GALBRAITH ROAD CINCINNATI OH 45216 HAMILTON 5134182500 362007 ELMWOOD HEALTHCARE CENTER AT THE SPRINGS 401 NORTH BROADWAY STREET GREEN SPRINGS OH 44836 SENECA 4196392626 362014 HEATHER HILL CARE COMMUNITIES 12340 BASS LAKE ROAD CHARDON OH 44024 GEAUGA 4402792443 362015 GRACE HOSPITAL 20000 HARVARD ROAD WARRENSVILLE HEIGHTS OH 44122 CUYAHOGA 2164917295 362016 SELECT SPECIALTY HOSPITAL‐NORTHEAST OHIO, INC 1320 MERCY DRIVE, 6TH FLOOR CANTON OH 44708 STARK 3304898198 362019 SELECT SPECIALTY HOSPITAL‐CINCINNATI, INC 375 DIXMYTH AVE, 15TH FLOOR CINCINNATI OH 45220 HAMILTON 5138624444 362020 KINDRED HOSPITAL LIMA 730 W MARKET ST LIMA OH 45801 ALLEN 4192241888 362021 KINDRED HOSPITAL CENTRAL OHIO 335 GLESSNER AVENUE, 5TH FLOOR MANSFIELD OH 44903 RICHLAND 4195260777 362022 SELECT SPECIALTY HOSPITAL‐COLUMBUS, INC 1087 DENNISON AVENUE, 2ND FLOOR COLUMBUS OH 43201 FRANKLIN 6144589000 362023 VIBRA HOSPITAL OF MAHONING VALLEY 8049 SOUTH AVENUE BOARDMAN OH 44512 MAHONING 3307265021 362024 SELECT SPECIALTY HOSPITAL ‐ YOUNGSTOWN 1044 BELMONT AVE YOUNGSTOWN OH 44501 MAHONING 3308414750 362025 COMMUNITY SPECIALTY HOSPITAL 254 CLEVELAND AVENUE, 2ND FLOOR AMHERST OH 44001 LORAIN 4409886141 362026 SELECT SPECIALTY HOSPITAL‐ CLEVELAND FAIRHILL 11900 FAIRHILL ROAD CLEVELAND OH 44120 CUYAHOGA 2169838030 362027 SELECT SPECIALTY HOSPITAL‐AKRON 200 EAST MARKET STREET AKRON OH 44308 SUMMIT 3307617500 362028 LIFE CARE HOSPITALS OF DAYTON 4000 MIAMISBURG‐CENTERVILLE ROAD MIAMISBURG OH 45342 MONTGOMERY 9373848300 362029 REGENCY HOSPITAL OF CLEVELAND EAST 4200 INTERCHANGE CORPORATE CENTER ROAD WARRENSVILLE HTS OH 44128 CUYAHOGA 3308612065 362031 SELECT SPECIALTY HOSPITAL SOUTHEAST OHIO 200 TAMARACK ROAD, 2ND FLOOR NEWARK OH 43055 LICKING 7405887888 362032 ACUTE CARE SPECIALTY HOSPITAL ‐ AULTMAN 2000 SIXTH STREET CANTON OH 44710 STARK 3303634000 362033 KINDRED HOSPITALS‐DAYTON 707 EAST EDWIN C MOSES BLVD DAYTON OH 45417 MONTGOMERY 9373319265 362034 REGENCY HOSPITAL OF CINCINNATI, LLC 10500 MONTGOMERY ROAD CINCINNATI OH 45219 HAMILTON 5135595957 362035 ACUITY SPECIALTY HOSPITAL OHIO VALLEY 4697 HARRISON STREET, 2ND FLOOR BELLAIRE OH 43906 BELMONT 7406712086 362036 REGENCY HOSPITAL OF TOLEDO 5220 WEST ALEXIS ROAD SYLVANIA OH 43560 LUCAS 4193185700 362037 SELECT SPECIALTY HOSPITAL COLUMBUS 1430 SOUTH HIGH STREET COLUMBUS OH 43207 FRANKLIN 6144560339 362038 ADVANCED SPECIALTY HOSPITAL OF TOLEDO 1015 GARDEN LAKE PARKWAY TOLEDO OH 43614 LUCAS 4193810037
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 161 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 362039 LIFE LINE HOSPITAL 200 SCHOOL STREET WINTERSVILLE OH 43953 JEFFERSON 7403462600 362040 SELECT SPECIALTY HOSPITAL YOUNGSTOWN 8401 MARKET STREET BOARDMAN OH 44512 MAHONING 3307291750 363026 HILLSIDE REHABILITATION HOSPITAL 8747 SQUIRES LANE NE WARREN OH 44484 TRUMBULL 3308413700 363032 GREENBRIAR REHABILITATION HOSPITAL 8064 SOUTH AVENUE, SUITE ONE BOARDMAN OH 44512 MAHONING 3309656432 363033 HEALTHSOUTH REHABILITATION HOSPITAL OF DAYTON ONE ELIZABETH PLACE DAYTON OH 45408 MONTGOMERY 9374248200
363034 HEALTHSOUTH REHABILITATION HOSPITAL OF CINCINNATI 151 WEST GALBRAITH ROAD CINCINNATI OH 45216 HAMILTON 5134185600
363035 SUMMA REHAB HOSPITAL 29 NORTH ADAMS STREET AKRON OH 44304 SUMMIT 3305727300 363036 UNIVERSITY HOSPITALS REHABILITATION HOSPITAL 23333 HARVARD ROAD BEACHWOOD OH 44122 CUYAHOGA 2165932200 363037 OHIOHEALTH REHABILITATION HOSPITAL 1087 DENNISON AVENUE 4TH FLOOR COLUMBUS OH 43201 FRANKLIN 6144589496 363038 CLEVELAND CLINIC REHABILITATION HOSPITALS LLC 33355 HEALTH CAMPUS BLVD AVON OH 44011 LORAIN 4409340489 363039 UNIVERSITY HOSPITALS AVON REHABILITATION HOSPITAL 37900 CHESTER ROAD AVON OH 44011 LORAIN 4406957101
363040 REHABILITATION HOSPITAL OF NORTHWEST OHIO LLC 1455 WEST MEDICAL LOOP TOLEDO OH 43614 LUCAS 4192146600
363041 TRIHEALTH REHABILITATION HOSPITAL LLC 2155 DANA AVENUE CINCINNATI OH 45207 HAMILTON 5136010600 363300 CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNET AVENUE CINCINNATI OH 45229 HAMILTON 5136363333 363302 RAINBOW BABIES AND CHILDRENS HOSPITAL 11100 EUCLID AVENUE CLEVELAND OH 44106 CUYAHOGA 2168441000 363303 AKRON CHILDREN'S HOSPITAL 1 PERKINS SQUARE AKRON OH 44308 SUMMIT 3305431000 363304 CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHAB 2801 MARTIN LUTHER KING, JR DRIVE CLEVELAND OH 44104 CUYAHOGA 2167216400
363305 NATIONWIDE CHILDREN'S HOSPITAL 700 CHILDREN'S DRIVE COLUMBUS OH 43205 FRANKLIN 6147222000 363306 DAYTON CHILDREN'S HOSPITAL ONE CHILDRENS PLAZA DAYTON OH 45404 MONTGOMERY 9376413450 363308 SHRINERS HOSPITALS FOR CHILDREN ‐ CINCINNATI 3229 BURNETT AVENUE CINCINNATI OH 45229 HAMILTON 5138726000 364007 TWIN VALLEY BEHAVIORAL HEALTHCARE 2200 WEST BROAD STREET COLUMBUS OH 43223 FRANKLIN 6147520333 364011 NORTHCOAST BEHAVIORAL HEALTHCARE NORTHFIELD 1756 SAGAMORE ROAD NORTHFIELD OH 44067 SUMMIT 3304677131 CAMPUS 364014 NORTHWEST OHIO PSYCHIATRIC HOSPITAL 930 SOUTH DETROIT AVENUE TOLEDO OH 43614 LUCAS 4193811881 364015 APPALACHIAN BEHAVIORAL HEALTH CARE 100 HOSPITAL DRIVE ATHENS OH 45701 ATHENS 6145945000 364027 CAMBRIDGE BEHAVIORAL HOSPITAL 66755 STATE STREET CAMBRIDGE OH 43725 GUERNSEY 7404324906 364029 WINDSOR LAURELWOOD CENTER FOR BEHAVORIAL 35900 EUCLID AVENUE WILLOUGHBY OH 44094 LAKE 4409533000 MEDICINE
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 162 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 364031 HEARTLAND BEHAVIORAL HEALTHCARE 3000 ERIE SW MASSILLON OH 44648 STARK 3308333135 364035 SUMMIT BEHAVIORAL HEALTHCARE 1101 SUMMIT ROAD CINCINNATI OH 45237 HAMILTON 5139483600 364036 ARROWHEAD BEHAVIORAL HEALTH 1725 TIMBER LINE ROAD MAUMEE OH 43537 LUCAS 4198919333 364038 BELMONT PINES HOSPITAL 615 CHURCHILL‐HUBBARD RD YOUNGSTOWN OH 44505 MAHONING 3307592700 364041 OHIO HOSPITAL FOR PSYCHIATRY 880 GREENLAWN AVENUE COLUMBUS OH 43223 FRANKLIN 6144499664 364042 TEN LAKES CENTER, LLC 819 NORTH FIRST STREET, 3RD FLOOR DENNISON OH 44621 TUSCARAWAS 7409227499 364044 LINDNER CENTER OF HOPE 4075 OLD WESTERN ROW ROAD MASON OH 45040 WARREN 5135364673 364045 POMEGRANATE HEALTH SYSTEMS OF COLUMBUS 765 PIERCE DRIVE COLUMBUS OH 43223 FRANKLIN 6142231650 364047 RIDGEVIEW BEHAVIORAL HOSPITAL 17872 LINCOLN HIGHWAY MIDDLE POINT OH 45863 VAN WERT 4199682950 364048 HAVEN BEHAVIORAL SENIOR CARE OF DAYTON ONE ELIZABETH PLACE, E3 SUITE A DAYTON OH 45417 MONTGOMERY 6152509500 364049 DUBLIN SPRINGS 7625 HOSPITAL DRIVE DUBLIN OH 43016 FRANKLIN 6147171800 364050 ACCESS HOSPITAL DAYTON, LLC 2611 WAYNE AVENUE DAYTON OH 45420 MONTGOMERY 9372567801 364051 BECKETT SPRINGS 8614 SHEPHERD FARM DRIVE WEST CHESTER OH 45069 BUTLER 5139429500 364052 CLEAR VISTA HEALTH & WELLNESS 3364 KOLBE ROAD LORAIN OH 44053 LORAIN 4402822244 364053 HIGHLAND SPRINGS 4199 MILL POND DRIVE BEACHWOOD OH 44122 CUYAHOGA 2163023070 364054 GENERATIONS BEHAVIORAL HEALTH ‐ GENEVA 60 WEST STREET GENEVA OH 44041 ASHTABULA 4404150794 369801 CLEVELAND CLINIC TRANSPLANT CENTER 9500 EUCLID AVENUE CLEVELAND OH 44106 CUYAHOGA 2164442200 369803 OHIO STATE UNIVERSITY HOSPITALS 410 WEST 10TH AVENUE COLUMBUS OH 43210 FRANKLIN 6142938000 369804 UNIVERSITY OF CINCINNATI MEDICAL CENTER 234 GOODMAN STREET CINCINNATI OH 45267 HAMILTON 5135841000 369805 UNIVERSITY OF TOLEDO MEDICAL CENTER 3000 ARLINGTON AVE TOLEDO OH 43614 LUCAS 4193833413 369806 CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNET AVENUE CINCINNATI OH 45229 HAMILTON 5136363333 369807 UNIVERSITY HOSPITALS CASE MEDICAL CENTER 11100 EUCLID AVENUE CLEVELAND OH 44106 CUYAHOGA 2168447064 369810 NATIONWIDE CHILDREN'S HOSPITAL 700 CHILDREN'S DRIVE COLUMBUS OH 43205 FRANKLIN 6147226592 369811 CHRIST HOSPITAL ‐ TRANSPLANT 2139 AUBURN AVENUE 5TH FLOOR CINCINNATI OH 45219 HAMILTON 5135852771 370001 HILLCREST MEDICAL CENTER 1120 SOUTH UTICA AVENUE TULSA OK 74104 TULSA 9185791000 370002 ALLIANCEHEALTH WOODWARD 900 17TH STREET WOODWARD OK 73801 WOODWARD 5802548492 370004 INTEGRIS MIAMI HOSPITAL 200 SECOND AVENUE SOUTHWEST MIAMI OK 74355 OTTAWA 9185426611 370006 ALLIANCEHEALTH PONCA CITY 1900 NORTH 14TH STREET PONCA CITY OK 74601 KAY 5807653301 370008 NORMAN REGIONAL HOSPITAL AUTHORITY 901 NORTH PORTER NORMAN OK 73070 CLEVELAND 4053071050 370011 MERCY HOSPITAL EL RENO 2115 PARKVIEW DRIVE EL RENO OK 73036 CANADIAN 4052622640
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 163 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 370013 MERCY HOSPITAL OKLAHOMA CITY, INC 4300 WEST MEMORIAL ROAD OKLAHOMA CITY OK 73120 OKLAHOMA 4057523754 370014 ALLIANCEHEALTH DURANT 1800 UNIVERSITY BOULEVARD DURANT OK 74702 BRYAN 4059243080 370015 ALLIANCEHEALTH PRYOR 111 NORTH BAILEY STREET PRYOR OK 74361 MAYES 9188251600 370016 INTEGRIS BASS BAPTIST HEALTH CENTER 600 SOUTH MONROE ENID OK 73701 GARFIELD 5802332300 370018 JANE PHILLIPS MEMORIAL MEDICAL CENTER, INC 3500 EAST FRANK PHILLIPS BOULEVARD BARTLESVILLE OK 74006 WASHINGTON 9183337200 370019 GREAT PLAINS REGIONAL MEDICAL CENTER 1801 WEST 3RD STREET ELK CITY OK 73644 BECKHAM 5802252511 370020 MERCY HOSPITAL ADA 430 NORTH MONTE VISTA ADA OK 74820 PONTOTOC 5803322323 370022 JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY 1200 EAST PECAN ST ALTUS OK 73523 JACKSON 5803795000 370023 DUNCAN REGIONAL HOSPITAL, INC 1407 WHISENANT DRIVE DUNCAN OK 73533 STEPHENS 5802525300 370025 EASTAR HEALTH SYSTEM 300 ROCKEFELLER DRIVE MUSKOGEE OK 74401 MUSKOGEE 9186825501 370026 ST MARY'S REGIONAL MEDICAL CENTER 305 SOUTH 5TH STREET ENID OK 73701 GARFIELD 5802336100 370028 INTEGRIS BAPTIST MEDICAL CENTER 3300 NORTHWEST EXPRESSWAY OKLAHOMA CITY OK 73112 OKLAHOMA 4059518110 370029 ALLIANCEHEALTH CLINTON 100 NORTH 30TH STREET CLINTON OK 73601 CUSTER 5803232363 370030 BLACKWELL REGIONAL HOSPITAL 710 SOUTH 13TH STREET BLACKWELL OK 74631 KAY 5803632311 370032 ALLIANCEHEALTH DEACONESS 5501 NORTH PORTLAND AVENUE OKLAHOMA CITY OK 73112 OKLAHOMA 4056046109 370034 MCALESTER REGIONAL HEALTH CENTER AUTHORITY ONE CLARK BASS BOULEVARD MCALESTER OK 74501 PITTSBURG 9184261800 370036 HARMON MEMORIAL HOSPITAL 400 EAST CHESTNUT STREET HOLLIS OK 73550 HARMON 5806883363 370037 ST ANTHONY HOSPITAL 1000 NORTH LEE AVENUE OKLAHOMA CITY OK 73101 OKLAHOMA 4052727000 370039 HILLCREST HOSPITAL CLAREMORE 1202 N MUSKOGEE PLACE CLAREMORE OK 74017 ROGERS 9183412556 370041 BRISTOW MEDICAL CENTER 700 W. 7TH STREET BRISTOW OK 74010 CREEK 9183672215 370047 MERCY HOSPITAL ARDMORE, INC 1011 FOURTEENTH AVENUE, NORTHWEST ARDMORE OK 73401 CARTER 5802235400 370048 MCCURTAIN MEMORIAL HOSPITAL 1301 LINCOLN ROAD IDABEL OK 74745 MCCURTAIN 5802867623 370049 STILLWATER MEDICAL CENTER 1323 WEST 6TH STREET STILLWATER OK 74076 PAYNE 4053721480 370054 GRADY MEMORIAL HOSPITAL 2220 IOWA STREET CHICKASHA OK 73018 GRADY 4052242300 370056 COMANCHE COUNTY MEMORIAL HOSPITAL 3401 WEST GORE BLVD LAWTON OK 73505 COMANCHE 5803558620 370057 MUSCOGEE (CREEK) NATION MEDICAL CENTER 1401 MORRIS DRIVE OKMULGEE OK 74447 OKMULGEE 9187564233 370065 CRAIG GENERAL HOSPITAL 735 NORTH FOREMAN VINITA OK 74301 CRAIG 9182567551 37006E CHILDRENS MEDICAL CENTER 5300 E SKELLY DR TULSA OK 74105 TULSA 370072 LATIMER COUNTY GENERAL HOSPITAL 806 STATE HIGHWAY 2 NORTH WILBURTON OK 74578 LATIMER 9184652391 370078 OKLAHOMA STATE UNIVERSITY MEDICAL CENTER 744 WEST 9TH STREET TULSA OK 74127 OSAGE 9185991000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 164 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 370080 SHARE MEDICAL CENTER 800 SHARE DRIVE ALVA OK 73717 WOODS 5803272800 370083 PUSHMATAHA COUNTY TOWN OF ANTLERS HOSPITAL 510 EAST MAIN STREET ANTLERS OK 74523 PUSHMATAHA 5802983341
370089 NORTHEASTERN HEALTH SYSTEM 1400 EAST DOWNING STREET TAHLEQUAH OK 74465 CHEROKEE 9184560641 370091 SAINT FRANCIS HOSPITAL, INC 6161 SOUTH YALE TULSA OK 74136 TULSA 9184942200 370093 O U MEDICAL CENTER 700 NE 13TH STREET OKLAHOMA CITY OK 73104 OKLAHOMA 4052715911 370094 ALLIANCEHEALTH MIDWEST 2825 PARKLAWN DRIVE MIDWEST CITY OK 73110 OKLAHOMA 4056108585 370097 SOUTHWESTERN MEDICAL CENTER 5602 SOUTHWEST LEE BOULEVARD LAWTON OK 73505 COMANCHE 5805314700 370099 HILLCREST HOSPITAL CUSHING 1027 EAST CHERRY STREET CUSHING OK 74023 PAYNE 9182252915 37009F FEDERAL REFORMATORY HOSP P O BOX 1000 EL RENO OK 73036 CANADIAN 370100 CHOCTAW MEMORIAL HOSPITAL 1405 EAST KIRK ROAD HUGO OK 74743 CHOCTAW 5803179500 370103 SAYRE MEMORIAL HOSPITAL, INC 911 HOSPITAL DRIVE SAYRE OK 73662 BECKHAM 5809285541 370106 INTEGRIS SOUTHWEST MEDICAL CENTER 4401 SOUTH WESTERN AVENUE OKLAHOMA CITY OK 73109 OKLAHOMA 4056367000 37010F US ARMY HOSP 462 HAMILTON RD FORT SILL OK 73503 COMANCHE 370112 SEQUOYAH COUNTY‐CITY OF SALLISAW HOSPITAL 213 EAST REDWOOD SALLISAW OK 74955 SEQUOYAH 9187741100 AUTHORIT 370113 INTEGRIS GROVE HOSPITAL 1001 EAST 18TH STREET GROVE OK 74344 DELAWARE 9187862243 370114 ST JOHN MEDICAL CENTER, INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 TULSA 9187443131 37012F VA HOSP HONOR HEIGHTS DR MUSKOGEE OK 74401 MUSKOGEE 370138 MEMORIAL HOSPITAL OF TEXAS COUNTY AUTHORITY 520 MEDICAL DRIVE GUYMON OK 73942 TEXAS 5803386515 370139 PERRY MEMORIAL HOSPITAL AUTHORITY 501 FOURTEENTH STREET PERRY OK 73077 NOBLE 5803363541 37013F US AIR FORCE HOSP TINKER AFB OKLAHOMA CITY OK 73145 OKLAHOMA 370149 ST ANTHONY SHAWNEE HOSPITAL 1102 W MACARTHUR SHAWNEE OK 74804 POTTAWATOMIE 4052732270 37014F VA HOSP 921 NE 13TH ST OKLAHOMA CITY OK 73104 OKLAHOMA 370153 ELKVIEW GENERAL HOSPITAL 429 WEST ELM STREET HOBART OK 73651 KIOWA 5807263324 370156 PAULS VALLEY HOSPITAL AUTHORITY 100 VALLEY DRIVE PAULS VALLEY OK 73075 GARVIN 4052385501 370158 PURCELL MUNICIPAL HOSPITAL 1500 NORTH GREEN AVENUE PURCELL OK 73080 MCCLAIN 4055276524 37015F US PUBLIC HEALTH SERVICE INDIAN HOSP 1120 GRAND AVE TAHLEQUAH OK 74464 CHEROKEE 370166 WAGONER COMMUNITY HOSPITAL 1200 WEST CHEROKEE STREET WAGONER OK 74467 WAGONER 9184855514 37016F US PUBLIC HEALTH SERVICE INDIAN HOSP TALIHINA OK 74571 LATIMER 370170 USPHS LAWTON INDIAN HOSPITAL 1515 LAWRIE TATUM ROAD LAWTON OK 73507 COMANCHE 5803545000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 165 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 370171 W W HASTINGS INDIAN HOSPITAL 100 S BLISS AVENUE TAHLEQUAH OK 74464 CHEROKEE 9184583100 370172 CHOCTAW NATION HEALTH SERVICES AUTHORITY 1 CHOCTAW WAY TALIHINA OK 74571 LATIMER 9185677000 370173 CLAREMORE INDIAN HOSPITAL 101 SOUTH MOORE AVE CLAREMORE OK 74017 ROGERS 9183418430 370178 MEMORIAL HOSPITAL 1401 WEST LOCUST STILWELL OK 74960 ADAIR 9186963101 370180 CHICKASAW NATION MEDICAL CENTER 1921 STONECIPHER BLVD ADA OK 74820 PONTOTOC 5804363980 370183 HILLCREST HOSPITAL HENRYETTA 2401 W MAIN DEWEY HENRYETTA OK 74437 OKMULGEE 9186501511 37018F US AIR FORCE HOSP ALTUS AFB ALTUS OK 73521 JACKSON 370190 SOUTHWESTERN REGIONAL MEDICAL CENTER, INC 10109 EAST 79TH STREET TULSA OK 74133 TULSA 9182865000 370192 NORTHWEST SURGICAL HOSPITAL 9204 NORTH MAY AVENUE OKLAHOMA CITY OK 73120 OKLAHOMA 4048481918 370199 LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE 11200 NORTH PORTLAND AVENUE OKLAHOMA CITY OK 73120 OKLAHOMA 4059361500
37019F US PUBLIC HEALTH SERVICE INDIAN HOSP ROUTE 1 CLINTON OK 73601 CUSTER 370201 SURGICAL HOSPITAL OF OKLAHOMA, LLC 100 SOUTHEAST 59TH STREET OKLAHOMA CITY OK 73129 OKLAHOMA 4056349300 370202 HILLCREST HOSPITAL SOUTH 8801 SOUTH 101ST EAST AVENUE TULSA OK 74133 TULSA 9182944000 370203 COMMUNITY HOSPITAL, LLC 3100 SOUTHWEST 89TH STREET OKLAHOMA CITY OK 73159 OKLAHOMA 4056028100 370206 OKLAHOMA SPINE HOSPITAL 14101 PARKWAY COMMONS DRIVE OKLAHOMA CITY OK 73134 OKLAHOMA 4057492700 37020F US PUBLIC HEALTH SERVICE INDIAN HOSP CLAREMORE OK 74017 ROGERS 370210 OKLAHOMA SURGICAL HOSPITAL, LLC 2408 EAST 81ST STREET, SUITE 300 TULSA OK 74137 TULSA 9184775095 370211 INTEGRIS CANADIAN VALLEY HOSPITAL 1201 HEALTH CENTER PARKWAY YUKON OK 73099 CANADIAN 4057176800 370212 OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI‐SP 8100 SOUTH WALKER BLDG COKLAHOMA CITY OK 73139 CLEVELAND 4056026500 370214 LINDSAY MUNICIPAL HOSPITAL 1305 W CHEROKEE STREET ‐ HIGHWAY 19 WEST LINDSAY OK 73052 GARVIN 4057561404 370215 OKLAHOMA HEART HOSPITAL, LLC 4050 WEST MEMORIAL ROAD OKLAHOMA CITY OK 73120 OKLAHOMA 4056083200 370216 TULSA SPINE & SPECIALTY HOSPITAL, LLC 6901 SOUTH OLYMPIA AVENUE TULSA OK 74132 TULSA 9183885701 370218 SAINT FRANCIS HOSPITAL SOUTH, LLC 10501 EAST 91ST STREET SOUTH TULSA OK 74133 TULSA 9183076000 37021F US PUBLIC HEALTH SERVICE INDIAN HOSP STAR RT LAWTON OK 73501 COMANCHE 5802322222 370220 ONECORE HEALTH 1044 SW 44TH, SUITE 350 OKLAHOMA CITY OK 73109 OKLAHOMA 4056313085 370222 MCBRIDE ORTHOPEDIC HOSPITAL 9600 NORTH BROADWAY EXTENSION OKLAHOMA CITY OK 73114 OKLAHOMA 4054862100 370225 SUMMIT MEDICAL CENTER 1800 SOUTH RENAISSANCE BOULEVARD EDMOND OK 73013 OKLAHOMA 4053592400 370227 ST JOHN OWASSO 12451 EAST 100TH STREET NORTH OWASSO OK 74055 TULSA 9182745100 370228 BAILEY MEDICAL CENTER, LLC 10502 NORTH 110TH EAST AVENUE OWASSO OK 74055 TULSA 9183768000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 166 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 370229 ALLIANCEHEALTH SEMINOLE 2401 WRANGLER BOULEVARD SEMINOLE OK 74868 SEMINOLE 4053034050 370233 PINNACLE SPECIALTY HOSPITAL 2408 EAST 81ST STREET, SUITE 600 TULSA OK 74137 TULSA 9183922780 370234 OKLAHOMA HEART HOSPITAL SOUTH, LLC 5200 EAST I‐240 SERVICE ROAD OKLAHOMA CITY OK 73135 OKLAHOMA 4056286000 370235 ST JOHN BROKEN ARROW, INC 1000 WEST BOISE CIRCLE BROKEN ARROW OK 74012 TULSA 9189948100 370236 INTEGRIS HEALTH EDMOND 4801 INTEGRIS PARKWAY EDMOND OK 73034 OKLAHOMA 4056573000 37027E ERICK HOSP 222 W BROADWAY ERICK OK 73645 BECKHAM 37032E EASTERN STATE HOSP P O BOX 69 VINITA OK 74301 CRAIG 37036E OKLAHOMA CEREBRAL PALSY CENTER EAST ALMEDA + S 12TH STS NORMAN OK 73069 CLEVELAND 37037E LYNN‐ANN CONV HOSP 211 S ROCK ISLAND GROVE OK 74344 DELAWARE 4051111111 37044E SHARE MEM HOSP 730 SHARE AVE ALVA OK 73717 WOODS 4053271131 37048E ENID STATE SCHOOL 2600 E WILLOW ST ENID OK 73701 GARFIELD 371300 ATOKA COUNTY MEDICAL CENTER 1200 WEST LIBERTY ROAD ATOKA OK 74525 ATOKA 5808893333 371301 PRAGUE COMMUNITY HOSPITAL 1322 KLABZUBA AVENUE PRAGUE OK 74864 LINCOLN 4055674922 371302 MERCY HOSPITAL WATONGA, INC 500 NORTH CLARENCE NASH BOULEVARD WATONGA OK 73772 BLAINE 5806237211 371303 ROGER MILLS MEMORIAL HOSPITAL 501 SOUTH L L MALES AVENUE CHEYENNE OK 73628 ROGER MILLS 5804973336 371304 MERCY HOSPITAL TISHOMINGO INC 1000 SOUTH BYRD TISHOMINGO OK 73460 JOHNSTON 5803712327 371305 JANE PHILLIPS NOWATA HOSPITAL, INC 237 SOUTH LOCUST STREET NOWATA OK 74048 NOWATA 9182733102 371306 MERCY HEALTH LOVE COUNTY 300 WANDA STREET MARIETTA OK 73448 LOVE 5802763347 371307 CIMARRON MEMORIAL HOSPITAL 100 SOUTH ELLIS BOISE CITY OK 73933 CIMARRON 5805442501 371309 PAWHUSKA HOSPITAL, INC 1101 EAST 15TH STREET PAWHUSKA OK 74056 OSAGE 9182873232 371310 MERCY HOSPITAL HEALDTON, INC. 3462 HOSPITAL RD HEALDTON OK 73438 CARTER 5802290701 371311 JEFFERSON COUNTY HOSPITAL INTERSECTION HYWS 81 & 70 WAURIKA OK 73573 JEFFERSON 5802282344 371312 ST JOHN SAPULPA, INC 1004 EAST BRYAN SAPULPA OK 74066 CREEK 9182278601 371313 MERCY HOSPITAL KINGFISHER 1000 KINGFISHER HOSPITAL DRIVE KINGFISHER OK 73750 KINGFISHER 4053753141 371314 THE PHYSICIANS' HOSPITAL IN ANADARKO 1002 EAST CENTRAL BOULEVARD ANADARKO OK 73005 CADDO 4052478236 371316 STROUD REGIONAL MEDICAL CENTER 2308 HIGHWAY 66 WEST STROUD OK 74079 LINCOLN 9189683571 371317 MERCY HOSPITAL LOGAN COUNTY, INC 200 SOUTH ACADEMY ROAD GUTHRIE OK 73044 LOGAN 4052826700 371318 FAIRFAX COMMUNITY HOSPITAL 40 HOSPITAL ROAD FAIRFAX OK 74637 OSAGE 9186423291 371319 MARY HURLEY HOSPITAL 6 NORTH COVINGTON COALGATE OK 74538 COAL 5809272327 371320 CLEVELAND AREA HOSPITAL 1401 WEST PAWNEE CLEVELAND OK 74020 PAWNEE 9183582501
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 167 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 371321 HOLDENVILLE GENERAL HOSPITAL 100 MCDOUGAL DRIVE HOLDENVILLE OK 74848 HUGHES 4053794200 371322 BEAVER COUNTY MEMORIAL HOSPITAL 212 EAST 8TH STREET BEAVER OK 73932 BEAVER 5806254551 371323 WEATHERFORD REGIONAL HOSPITAL, INC OF 3701 E MAIN WEATHERFORD OK 73096 CUSTER 5807725551 WEATHERFORD 371324 HARPER COUNTY COMMUNITY HOSPITAL 1003 US HIGHWAY 64 NORTH BUFFALO OK 73834 HARPER 5807352555 371325 CORDELL MEMORIAL HOSPITAL 1220 NORTH GLENN ENGLISH STREET CORDELL OK 73632 WASHITA 5808323339 371326 ALLIANCEHEALTH MADILL 901 S 5TH AVE MADILL OK 73446 MARSHALL 5807953384 371327 OKEENE MUNICIPAL HOSPITAL 207 EAST F STREET OKEENE OK 73763 BLAINE 5808224417 371328 ARBUCKLE MEMORIAL HOSPITAL AUTHORITY 2011 WEST BROADWAY SULPHUR OK 73086 MURRAY 5806222161 371329 FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY 523 EAST STATE ROAD FAIRVIEW OK 73737 MAJOR 5802273721 371330 QUARTZ MOUNTAIN MEDICAL CENTER ONE WICKERSHAM DRIVE MANGUM OK 73554 GREER 5807823353 371331 DRUMRIGHT REGIONAL HOSPITAL 610 WEST BYPASS DRUMRIGHT OK 74030 CREEK 9183822300 371332 SEILING MUNICIPAL HOSPITAL US HIGHWAY 60 SEILING OK 73663 DEWEY 5809227361 371333 CREEK NATION COMMUNITY HOSPITAL 309 NORTH 14TH STREET OKEMAH OK 74859 OKFUSKEE 9186231424 371334 CARNEGIE TRI‐COUNTY MUNICIPAL HOSPITAL 102 NORTH BROADWAY CARNEGIE OK 73015 CADDO 5806541050 371335 HASKELL COUNTY COMMUNITY HOSPITAL 401 NORTHWEST H STREET STIGLER OK 74462 HASKELL 9189674682 371336 NEWMAN MEMORIAL HOSPITAL 905 SOUTH MAIN STREET SHATTUCK OK 73858 ELLIS 5809382551 372004 KINDRED HOSPITAL ‐ OKLAHOMA CITY 1407 NORTH ROBINSON AVENUE OKLAHOMA CITY OK 73103 OKLAHOMA 4052328000 372005 EDMOND ‐ AMG SPECIALTY HOSPITAL 1100 EAST 9TH STREET EDMOND OK 73034 OKLAHOMA 4053415617 372007 SELECT SPECIALTY HOSPITAL ‐ TULSA/MIDTOWN, LLC 1125 SOUTH TRENTON, 2ND & 3RD FLOOR TULSA OK 74120 TULSA 9185797301 372009 SELECT SPECIALTY HOSPITAL ‐ OKLAHOMA CITY, INC 3524 NORTHWEST 56TH STREET OKLAHOMA CITY OK 73112 OKLAHOMA 4056066700 372011 TULSA‐AMG SPECIALTY HOSPITAL, LLC 2408 E 81ST STREET, STE 2800 TULSA OK 74137 TULSA 9187103620 372012 SPECIALTY HOSPITAL OF MIDWEST CITY 8210 NATIONAL AVENUE MIDWEST CITY OK 73110 OKLAHOMA 4057390800 372016 INTEGRIS BASS PAVILION 401 SOUTH THIRD STREET ENID OK 73701 GARFIELD 5802494260 372017 LANE FROST HEALTH AND REHABILITATION CENTER 2815 EAST JACKSON HUGO OK 74743 CHOCTAW 5803269200 372018 PAM SPECIALTY HOSPITAL OF TULSA 3219 SOUTH 79TH EAST AVENUE TULSA OK 74145 TULSA 9186638183 372019 CHG CORNERSTONE HOSPITAL OF OKLAHOMA ‐ SHAWNEE 1900 GORDON COOPER DRIVE, 2ND FLOOR SHAWNEE OK 74801 POTTAWATOMIE 4053955800
372021 NORMAN SPECIALTY HOSPITAL 1210 WEST ROBINSON NORMAN OK 73069 CLEVELAND 4053218824 372022 CORNERSTONE HOSPITAL OF OKLAHOMA‐ MUSKOGEE 351 SOUTH 40TH STREET MUSKOGEE OK 74401 MUSKOGEE 9186826161
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 168 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 372023 MUSCOGEE (CREEK) NATION LONG TERM ACUTE CARE 900 EAST AIRPORT ROAD OKMULGEE OK 74447 OKMULGEE 9187569211 HOSPI 373025 VALIR REHABILITATION HOSPITAL OF OKC 700 NORTHWEST 7TH STREET OKLAHOMA CITY OK 73102 OKLAHOMA 4052363131 373026 MUSCOGEE (CREEK) NATION PHYSICAL REHABILITATION CE 900 EAST AIRPORT ROAD OKMULGEE OK 74447 OKMULGEE 9187569211
373033 MERCY REHABILITATION HOSPITAL OKLAHOMA CITY 5401 WEST MEMORIAL ROAD OKLAHOMA CITY OK 73142 OKLAHOMA 4053845250 373300 J D MCCARTY CENTER FOR CHILDREN 2002 EAST ROBINSON NORMAN OK 73071 CLEVELAND 4053072800 374000 GRIFFIN MEMORIAL HOSPITAL 900 EAST MAIN STREET NORMAN OK 73070 CLEVELAND 4053214880 374001 NORTHWEST CENTER FOR BEHAVIORAL HEALTH (NCBH) 1 MILE EAST US HIGHWAY 270 FORT SUPPLY OK 73841 WOODWARD 5807662311
374006 CARL ALBERT COMMUNITY MENTAL HEALTH CENTER 1101 EAST MONROE MCALESTER OK 74501 PITTSBURG 9184267800 374008 JIM TALIAFERRO COMM MENTAL HEALTH CTR 602 SOUTHWEST 38TH STREET LAWTON OK 73505 COMANCHE 5802485780 374012 BROOKHAVEN HOSPITAL, INC 201 SOUTH GARNETT ROAD TULSA OK 74128 TULSA 9184384257 374016 ROLLING HILLS HOSPITAL, LLC 1000 ROLLING HILLS LANE ADA OK 74820 PONTOTOC 5804363600 374017 WILLOW CREST HOSPITAL 130 A STREET SOUTHWEST MIAMI OK 74354 OTTAWA 9185421836 374020 LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL, INC 6655 SOUTH YALE AVENUE TULSA OK 74136 TULSA 9184814000 374021 PARKSIDE, INC 1619 EAST 13TH STREET TULSA OK 74120 TULSA 9185822131 374023 CEDAR RIDGE 6501 NORTHEAST 50TH STREET OKLAHOMA CITY OK 73141 OKLAHOMA 4056056111 374024 SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM 6262 SOUTH SHERIDAN ROAD TULSA OK 74133 TULSA 9184928200 379801 O U MEDICAL CENTER 1200 EVERETT DR OKLAHOMA CITY OK 73117 OKLAHOMA 4052717498 379802 ST ANTHONY HOSPITAL 1000 NORTH LEE AVE OKLAHOMA CITY OK 73101 OKLAHOMA 4052727000 379803 INTEGRIS BAPTIST MEDICAL CENTER 3300 NORTHWEST EXPRESSWAY OKLAHOMA CITY OK 73112 OKLAHOMA 4059493011 379804 ST JOHN MEDICAL CENTER‐TRANSPLANT 1923 S UTICA AVE TULSA OK 74104 TULSA 9187443537 379805 SAINT FRANCIS HOSPITAL 6161 SOUTH YALE AVENUE TULSA OK 74136 TULSA 9184948467 379806 OU MEDICAL CENTER ‐ PRESBYTERIAN TOWER 700 NE 13TH STREET OKLAHOMA CITY OK 73104 OKLAHOMA 4052717498 380001 MID‐COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 WASCO 5412961111 380002 ASANTE THREE RIVERS MEDICAL CENTER 500 SW RAMSEY AVENUE GRANTS PASS OR 97527 JOSEPHINE 5414727000 380004 PROVIDENCE ST VINCENT MEDICAL CENTER 9205 SW BARNES ROAD PORTLAND OR 97225 WASHINGTON 5032162213 380005 ASANTE ASHLAND COMMUNITY HOSPITAL 280 MAPLE STREET ASHLAND OR 97520 JACKSON 5412014001 380007 LEGACY EMANUEL MEDICAL CENTER 2801 N GANTENBEIN AVENUE PORTLAND OR 97227 MULTNOMAH 5034132200 380009 OHSU HOSPITAL AND CLINICS 3181 SW SAM JACKSON PARK ROAD PORTLAND OR 97239 MULTNOMAH 5034944036
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 169 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 380014 GOOD SAMARITAN REGIONAL MEDICAL CENTER 3600 NW SAMARITAN DRIVE CORVALLIS OR 97330 BENTON 5417685111 380017 LEGACY GOOD SAMARITAN MEDICAL CENTER 1015 NW 22ND AVENUE, W121 PORTLAND OR 97210 MULTNOMAH 5034137682 380018 ASANTE ROGUE REGIONAL MEDICAL CENTER 2825 E BARNETT ROAD MEDFORD OR 97504 JACKSON 5417897000 380020 MCKENZIE‐WILLAMETTE MEDICAL CENTER 1460 G STREET SPRINGFIELD OR 97477 LANE 5417264400 380021 TUALITY COMMUNITY HOSPITAL 335 SE 8TH AVENUE HILLSBORO OR 97123 WASHINGTON 5036811111 380022 SAMARITAN ALBANY GENERAL HOSPITAL 1046 6TH AVENUE SW ALBANY OR 97321 LINN 5418124000 380025 LEGACY MOUNT HOOD MEDICAL CENTER 24800 SE STARK STREET GRESHAM OR 97030 MULTNOMAH 5036741122 380027 MERCY MEDICAL CENTER 2700 NW STEWART PARKWAY ROSEBURG OR 97471 DOUGLAS 5416730611 380029 SILVERTON HOSPITAL 342 FAIRVIEW STREET SILVERTON OR 97381 MARION 5038731500 38002E OREGON STATE HOSPITAL‐ SALEM 2600 CENTER STREET NE SALEM OR 97301 MARION 5039452870 380033 SACRED HEART UNIVERSITY DISTRICT 1255 HILYARD STREET EUGENE OR 97401 LANE 5416867300 380037 PROVIDENCE NEWBERG MEDICAL CENTER 1001 PROVIDENCE DRIVE NEWBERG OR 97132 YAMHILL 5035371555 380038 PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER 1500 DIVISION STREET OREGON CITY OR 97045 CLACKAMAS 5036576915 38003F VA HOSP SAM JACKSON PARK RD PORTLAND OR 97207 MULTNOMAH 380040 ST CHARLES MEDICAL CENTER ‐ REDMOND 1253 N CANAL BLVD REDMOND OR 97756 DESCHUTES 5415488131 380047 ST CHARLES MEDICAL CENTER ‐ BEND 2500 NE NEFF ROAD BEND OR 97701 DESCHUTES 5417066879 38004F VA HOSP 1440 W HARVARD BLVD ROSEBURG OR 97470 DOUGLAS 380050 SKY LAKES MEDICAL CENTER 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 KLAMATH 5412746150 380051 SALEM HOSPITAL 890 OAK STREET, SE SALEM OR 97301 MARION 5035615200 380052 SAINT ALPHONSUS MEDICAL CENTER ‐ ONTARIO, INC 351 SW 9TH STREET ONTARIO OR 97914 MALHEUR 5418817000 380056 SANTIAM MEMORIAL HOSPITAL 1401 N 10TH AVENUE STAYTON OR 97383 MARION 5037692175 380060 ADVENTIST MEDICAL CENTER 10123 SE MARKET STREET PORTLAND OR 97216 MULTNOMAH 5032572500 380061 PROVIDENCE PORTLAND MEDICAL CENTER 4805 NE GLISAN STREET PORTLAND OR 97213 MULTNOMAH 5032151111 380071 WILLAMETTE VALLEY MEDICAL CENTER 2700 SE STRATUS AVE. MCMINNVILLE OR 97128 YAMHILL 5034726131 380075 PROVIDENCE MEDFORD MEDICAL CENTER 1111 CRATER LAKE AVENUE MEDFORD OR 97504 JACKSON 5417325196 380082 PROVIDENCE MILWAUKIE HOSPITAL 10150 SE 32ND AVENUE MILWAUKIE OR 97222 CLACKAMAS 5035138336 380089 LEGACY MERIDIAN PARK MEDICAL CENTER 19300 SW 65TH AVENUE TUALATIN OR 97062 WASHINGTON 5036922182 380090 BAY AREA HOSPITAL 1775 THOMPSON ROAD COOS BAY OR 97420 COOS 5412698124 380091 KAISER SUNNYSIDE MEDICAL CENTER 10180 SE SUNNYSIDE ROAD CLACKAMAS OR 97015 CLACKAMAS 5035712880 380102 SACRED HEART MEDICAL CENTER ‐ RIVERBEND 3333 RIVERBEND DRIVE SPRINGFIELD OR 97477 LANE 5412227300
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 170 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 380103 KAISER FOUNDATION HOSPITAL ‐ WESTSIDE 2875 NW STUCKI AVE HILLSBORO OR 97124 WASHINGTON 9713101000 381301 PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL 1515 VILLAGE DRIVE COTTAGE GROVE OR 97424 LANE 5417675500 CENTER 381302 SAMARITAN NORTH LINCOLN HOSPITAL 3043 NE 28TH STREET LINCOLN CITY OR 97367 LINCOLN 5419943661 381303 PROVIDENCE SEASIDE HOSPITAL 725 S WAHANNA ROAD SEASIDE OR 97138 CLATSOP 5037177000 381304 SOUTHERN COOS HOSPITAL & HEALTH CENTER 900 11TH STREET SE BANDON OR 97411 COOS 5413472426 381305 BLUE MOUNTAIN HOSPITAL 170 FORD ROAD JOHN DAY OR 97845 GRANT 5415751311 381306 WALLOWA MEMORIAL HOSPITAL 601 MEDICAL PARKWAY ENTERPRISE OR 97828 WALLOWA 5414263111 381307 HARNEY DISTRICT HOSPITAL 557 W WASHINGTON STREET BURNS OR 97720 HARNEY 5415737281 381308 WEST VALLEY HOSPITAL 525 SE WASHINGTON STREET DALLAS OR 97338 POLK 5036238301 381309 LAKE DISTRICT HOSPITAL 700 SOUTH J STREET LAKEVIEW OR 97630 LAKE 5419472114 381310 PIONEER MEMORIAL HOSPITAL 564 E PIONEER DRIVE HEPPNER OR 97836 MORROW 5416769133 381311 LOWER UMPQUA HOSPITAL DISTRICT 600 RANCH ROAD REEDSPORT OR 97467 DOUGLAS 5412712171 381312 COQUILLE VALLEY HOSPITAL DISTRICT 940 EAST 5TH STREET COQUILLE OR 97423 COOS 5413963101 381313 ST CHARLES PRINEVILLE 384 SE COMBS FLAT ROAD PRINEVILLE OR 97754 CROOK 5414478424 381314 SAMARITAN PACIFIC COMMUNITY HOSPITAL 930 SW ABBEY STREET NEWPORT OR 97365 LINCOLN 5412652244 381315 SAINT ALPHONSUS MEDICAL CENTER ‐ BAKER CITY, INC 3325 POCAHONTAS ROAD BAKER CITY OR 97814 BAKER 5415236461
381316 PEACE HARBOR MEDICAL CENTER 400 9TH STREET FLORENCE OR 97439 LANE 5419978412 381317 TILLAMOOK REGIONAL MEDICAL CENTER 1000 THIRD STREET TILLAMOOK OR 97141 TILLAMOOK 5038424444 381318 PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL 810 12TH STREET HOOD RIVER OR 97031 HOOD RIVER 5413863911 381319 ST ANTHONY HOSPITAL 2801 ST ANTHONY WAY PENDLETON OR 97801 UMATILLA 5412765121 381320 COLUMBIA MEMORIAL HOSPITAL 2111 EXCHANGE STREET ASTORIA OR 97103 CLATSOP 5033254321 381321 GRANDE RONDE HOSPITAL 900 SUNSET DRIVE LA GRANDE OR 97850 UNION 5419638421 381322 CURRY GENERAL HOSPITAL 94220 FOURTH STREET GOLD BEACH OR 97444 CURRY 5412473000 381323 SAMARITAN LEBANON COMMUNITY HOSPITAL 525 N SANTIAM HIGHWAY LEBANON OR 97355 LINN 5412582101 381324 ST CHARLES ‐ MADRAS 470 NE A STREET MADRAS OR 97741 JEFFERSON 5414753882 381325 GOOD SHEPHERD MEDICAL CENTER 610 NW 11TH STREET HERMISTON OR 97838 UMATILLA 5416673400 382004 VIBRA SPECIALTY HOSPITAL OF PORTLAND 10300 NE HANCOCK STREET PORTLAND OR 97220 MULTNOMAH 5032575500 383300 SHRINERS HOSPITAL FOR CHILDREN‐PORTLAND 3101 SW SAM JACKSON PARK ROAD PORTLAND OR 97239 MULTNOMAH 5032415090 384008 OREGON STATE HOSPITAL DISTINCT PART 2600 CENTER STREET NE SALEM OR 97301 MARION 5039452870
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 171 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 384012 CEDAR HILLS HOSPITAL 10300 SW EASTRIDGE STREET PORTLAND OR 97225 WASHINGTON 5039445000 389800 OHSU TRANSPLANT HOSPITAL 3181 SW SAM JACKSON PARK ROAD PORTLAND OR 97239 MULTNOMAH 5034946096 389801 LEGACY TRANSPLANT SERVICES 1015 NW 22 AVE PORTLAND OR 97210 MULTNOMAH 5034136722 390001 GEISINGER ‐ COMMUNITY MEDICAL CENTER 1822 MULBERRY STREET SCRANTON PA 18510 LACKAWANNA 5709698240 390002 UPMC MCKEESPORT 1500 FIFTH AVENUE MC KEESPORT PA 15132 ALLEGHENY 4126642000 390003 GEISINGER ‐ BLOOMSBURG HOSPITAL 549 EAST FAIR STREET BLOOMSBURG PA 17815 COLUMBIA 5703872100 390004 HOLY SPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL PA 17011 CUMBERLAND 7177632100 390006 GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE DANVILLE PA 17822 MONTOUR 5702716211 390008 ELLWOOD CITY HOSPITAL 724 PERSHING STREET ELLWOOD CITY PA 16117 LAWRENCE 7247520081 390009 SAINT VINCENT HOSPITAL 232 WEST 25TH STREET ERIE PA 16544 ERIE 8144525000 390012 LANSDALE HOSPITAL 100 MEDICAL CAMPUS DRIVE LANSDALE PA 19446 MONTGOMERY 2153682100 390013 EVANGELICAL COMMUNITY HOSPITAL ONE HOSPITAL DRIVE LEWISBURG PA 17837 UNION 5705222200 390016 JAMESON MEMORIAL HOSPITAL 1211 WILMINGTON AVENUE NEW CASTLE PA 16105 LAWRENCE 7246589001 390019 PALMERTON HOSPITAL 135 LAFAYETTE AVENUE PALMERTON PA 18071 CARBON 6108263141 39001F JAMES E VAN ZANDT VA MEDICAL CENTER (ALTOONA) 2907 PLEASANT VALLEY BOULEVARD ALTOONA PA 16602 BLAIR 8149438164 390025 KENSINGTON HOSPITAL 136 W DIAMOND STREET PHILADELPHIA PA 19122 2154268100 390026 CHESTNUT HILL HOSPITAL 8835 GERMANTOWN AVE PHILADELPHIA PA 19118 2152488200 390027 TEMPLE UNIVERSITY HOSPITAL 3401 NORTH BROAD STREET PHILADELPHIA PA 19140 2157072000 390028 UPMC MERCY 1400 LOCUST STREET PITTSBURGH PA 15219 ALLEGHENY 4122328111 39002F BUTLER VA MEDICAL CENTER 325 NEW CASTLE ROAD BUTLER PA 16001 BUTLER 7242874781 390030 SCHUYLKILL MEDICAL CENTER ‐ SOUTH JACKSON STREET 420 SOUTH JACKSON STREET POTTSVILLE PA 17901 SCHUYLKILL 5706215000
390031 SCHUYLKILL MEDICAL CENTER ‐ EAST NORWEGIAN STREET 700 EAST NORWEGIAN STREET POTTSVILLE PA 17901 SCHUYLKILL 5706214000
390032 ALLEGHENY VALLEY HOSPITAL 1301 CARLISLE ST NATRONA PA 15065 ALLEGHENY 4122245100 390035 ST LUKE'S QUAKERTOWN HOSPITAL 1021 PARK AVENUE QUAKERTOWN PA 18951 BUCKS 2155384500 390036 HERITAGE VALLEY BEAVER 1000 DUTCH RIDGE ROAD BEAVER PA 15009 BEAVER 4127287000 390037 HERITAGE VALLEY SEWICKLEY 720 BLACKBURN ROAD SEWICKLEY PA 15143 ALLEGHENY 4127417000 390039 SOMERSET HOSPITAL 225 SOUTH CENTER AVENUE SOMERSET PA 15501 SOMERSET 8144435000 390041 UNIONTOWN HOSPITAL 500 WEST BERKELEY STREET UNIONTOWN PA 15401 FAYETTE 7244305000 390042 WASHINGTON HOSPITAL, THE 155 WILSON AVENUE WASHINGTON PA 15301 WASHINGTON 7242257000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 172 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 390043 SOLDIERS AND SAILORS MEMORIAL HOSPITAL 32‐36 CENTRAL AVENUE WELLSBORO PA 16901 TIOGA 5707241631 390044 READING HOSPITAL SIXTH AVENUE AND SPRUCE ST READING PA 19603 BERKS 6109888000 390045 WILLIAMSPORT REGIONAL MEDICAL CENTER 700 HIGH STREET WILLIAMSPORT PA 17701 LYCOMING 5703211000 390046 YORK HOSPITAL 1001 SOUTH GEORGE STREET YORK PA 17403 YORK 7178512345 390048 GEISINGER‐LEWISTOWN HOSPITAL 400 HIGHLAND AVENUE LEWISTOWN PA 17044 MIFFLIN 7172485411 390049 ST LUKE'S HOSPITAL BETHLEHEM 801 OSTRUM STREET BETHLEHEM PA 18015 NORTHAMPTON 6109544000 39004F COATESVILLE VA MEDICAL CENTER 1400 BLACK HORSE HILL ROAD COATESVILLE PA 19320 CHESTER 6103847711 390050 ALLEGHENY GENERAL HOSPITAL 320 EAST NORTH AVENUE PITTSBURGH PA 15212 ALLEGHENY 4123593131 390052 CLEARFIELD HOSPITAL 809 TURNPIKE AVE CLEARFIELD PA 16830 CLEARFIELD 8147682497 390056 J C BLAIR MEMORIAL HOSPITAL 1225 WARM SPRINGS AVE HUNTINGDON PA 16652 HUNTINGDON 8146432290 390057 GRAND VIEW HOSPITAL 700 LAWN AVENUE SELLERSVILLE PA 18960 BUCKS 2154534615 390058 CARLISLE REGIONAL MEDICAL CENTER 361 ALEXANDER SPRING ROAD CARLISLE PA 17015 CUMBERLAND 7172491212 39005F ERIE VA MEDICAL CENTER 135 E 38TH ST ERIE PA 16504 ERIE 8148688661 390061 LANCASTER REGIONAL MEDICAL CENTER 250 COLLEGE AVENUE LANCASTER PA 17604 LANCASTER 7172918123 390062 NASON HOSPITAL 105 NASON DRIVE ROARING SPRING PA 16673 BLAIR 8142242141 390063 UPMC HAMOT 201 STATE STREET ERIE PA 16550 ERIE 8148776000 390065 GETTYSBURG HOSPITAL 147 GETTYS STREET GETTYSBURG PA 17325 ADAMS 7173342121 390066 GOOD SAMARITAN HOSPITAL FOURTH AND WALNUT STREETS LEBANON PA 17042 LEBANON 7172707500 390067 PINNACLE HEALTH HOSPITALS 409 SOUTH SECOND STREET HARRISBURG PA 17105 DAUPHIN 7177825181 390068 HEART OF LANCASTER REGIONAL MEDICAL CENTER 1500 HIGHLANDS DRIVE LITITZ PA 17543 LANCASTER 7176255000 39006F LEBANON VA MEDICAL CENTER 1700 SOUTH LINCOLN AVENUE LEBANON PA 17042 LEBANON 7172726621 390070 LOWER BUCKS HOSPITAL 501 BATH ROAD BRISTOL PA 19007 BUCKS 2157859200 390071 LOCK HAVEN HOSPITAL 24 CREE DRIVE LOCK HAVEN PA 17745 CLINTON 5708935000 390072 BERWICK HOSPITAL CENTER 701 EAST 16TH STREET BERWICK PA 18603 COLUMBIA 5707595000 390073 UPMC ALTOONA 620 HOWARD AVENUE ALTOONA PA 16601 BLAIR 8148892011 390076 BRANDYWINE HOSPITAL 201 REECEVILLE ROAD COATESVILLE PA 19320 CHESTER 6103838000 390079 ROBERT PACKER HOSPITAL ONE GUTHRIE SQUARE SAYRE PA 18840 BRADFORD 5708886666 390080 JEANES HOSPITAL 7600 CENTRAL AVENUE PHILADELPHIA PA 19111 2157282000 390081 DELAWARE COUNTY MEMORIAL HOSPITAL 501 NORTH LANSDOWNE AVE DREXEL HILL PA 19026 DELAWARE 2152848100 390084 SUNBURY COMMUNITY HOSPITAL 350 NORTH 11TH STREET SUNBURY PA 17801 NORTHUMBERLAND 5702863333
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 173 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 390086 PENN HIGHLANDS DUBOIS 100 HOSPITAL AVENUE DUBOIS PA 15801 CLEARFIELD 8143712200 390090 WESTERN PENNSYLVANIA HOSPITAL 4800 FRIENDSHIP AVENUE PITTSBURGH PA 15224 ALLEGHENY 4125785000 390091 UPMC NORTHWEST 100 FAIRFIELD DRIVE SENECA PA 16346 VENANGO 8146767600 390093 CLARION HOSPITAL ONE HOSPITAL DRIVE CLARION PA 16214 CLARION 8142269500 390096 ST JOSEPH MEDICAL CENTER 2500 BERNVILLE ROAD READING PA 19605 BERKS 6103782300 390097 HOLY REDEEMER HOSPITAL AND MEDICAL CENTER 1648 HUNTINGDON PIKE MEADOWBROOK PA 19046 MONTGOMERY 2159473000 39009F PHILADELPHIA VA MEDICAL CENTER UNIVERSITY AND WOODLAND AVENUES PHILADELPHIA PA 19104 2158235800 390100 LANCASTER GENERAL HOSPITAL 555 NORTH DUKE STREET LANCASTER PA 17604 LANCASTER 7172995511 390101 MEMORIAL HOSPITAL 325 SOUTH BELMONT STREET YORK PA 17403 YORK 7178438623 390102 UPMC ST MARGARET 815 FREEPORT ROAD PITTSBURGH PA 15215 ALLEGHENY 4127844000 390104 KANE COMMUNITY HOSPITAL 4372 ROUTE 6 KANE PA 16735 MCKEAN 8148378585 390107 UPMC PASSAVANT 9100 BABCOCK BOULEVARD PITTSBURGH PA 15237 ALLEGHENY 4123676700 390110 MEMORIAL MEDICAL CENTER 1086 FRANKLIN STREET JOHNSTOWN PA 15905 CAMBRIA 8145349000 390111 HOSPITAL OF UNIV OF PENNSYLVANIA 34TH & SPRUCE STS PHILADELPHIA PA 19104 2156623227 390112 WINDBER HOSPITAL 600 SOMERSET AVENUE WINDBER PA 15963 SOMERSET 8144673000 390113 MEADVILLE MEDICAL CENTER 751 LIBERTY STREET MEADVILLE PA 16335 CRAWFORD 8143335000 390114 MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM 300 HALKET STREET PITTSBURGH PA 15213 ALLEGHENY 4126414010
390115 ARIA HEALTH 10800 KNIGHTS ROAD PHILADELPHIA PA 19114 2156124129 390116 SUBURBAN COMMUNITY HOSPITAL 2701 DEKALB PIKE NORRISTOWN PA 19401 MONTGOMERY 2152782000 390117 UPMC BEDFORD MEMORIAL 10455 LINCOLN HIGHWAY EVERETT PA 15537 BEDFORD 8146236161 390118 BRADFORD REGIONAL MEDICAL CENTER 116 INTERSTATE PARKWAY BRADFORD PA 16701 MCKEAN 8143684143 390119 MOSES TAYLOR HOSPITAL 700 QUINCY AVENUE SCRANTON PA 18510 LACKAWANNA 5703402100 39011F VA PITTSBURGH HEALTHCARE SYS, HIGHLAND DRIVE DIV 7180 HIGHLAND DRIVE PITTSBURGH PA 15206 ALLEGHENY 4123654900
390123 POTTSTOWN MEMORIAL MEDICAL CENTER 1600 EAST HIGH STREET AND ARMAND HAMMER BLVD POTTSTOWN PA 19464 MONTGOMERY 6103277000
390125 WAYNE MEMORIAL HOSPITAL 601 PARK STREET HONESDALE PA 18431 WAYNE 5702538100 390127 PHOENIXVILLE HOSPITAL 140 NUTT ROAD PHOENIXVILLE PA 19460 CHESTER 6109831000 39012F VA PITTSURGH HEALTHCARE SYST, UNIVERSITY DRIVE DIV UNIVERSITY DRIVE PITTSBURGH PA 15240 ALLEGHENY 4126886000
390130 CONEMAUGH MINERS MEDICAL CENTER 290 HAIDA AVENUE HASTINGS PA 16646 CAMBRIA 8142473100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 174 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 390133 LEHIGH VALLEY HOSPITAL 1200 SOUTH CEDAR CREST BOULVARD ALLENTOWN PA 18105 LEHIGH 6104022273 390137 WILKES‐BARRE GENERAL HOSPITAL 575 NORTH RIVER STREET WILKES‐BARRE PA 18764 LUZERNE 5708298111 390138 WAYNESBORO HOSPITAL 501 EAST MAIN ST WAYNESBORO PA 17268 FRANKLIN 7177654000 390139 MAIN LINE HOSPITAL BRYN MAWR CAMPUS 130 SOUTH BRYN MAWR AVE BRYN MAWR PA 19010 DELAWARE 6105263000 39013F WILKES‐BARRE VA MEDICAL CENTER 1111 EAST END BLVD WILKES BARRE PA 18711 LUZERNE 5708243521 390142 ALBERT EINSTEIN MEDICAL CENTER 5501 OLD YORK ROAD PHILADELPHIA PA 19141 2154566090 390145 EXCELA HEALTH WESTMORELAND HOSPITAL 532 WEST PITTSBURGH STREET GREENSBURG PA 15601 WESTMORELAND 4128325050 390146 WARREN GENERAL HOSPITAL TWO CRESCENT PARK WEST WARREN PA 16365 WARREN 8147233300 390147 MONONGAHELA VALLEY HOSPITAL 1163 COUNTRY CLUB ROAD MONONGAHELA PA 15063 WASHINGTON 7242581000 390150 WASHINGTON HEALTH SYSTEM GREENE 350 BONAR AVENUE WAYNESBURG PA 15370 GREENE 7246272602 390151 CHAMBERSBURG HOSPITAL 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 FRANKLIN 7172673000 390153 MAIN LINE HOSPITAL PAOLI 255 WEST LANCASTER AVENUE PAOLI PA 19301 CHESTER 6106481000 390156 MERCY FITZGERALD HOSPITAL LANSDOWNE & BAILY RDS DARBY PA 19023 DELAWARE 2152374000 390157 OHIO VALLEY GENERAL HOSPITAL 25 HECKEL ROAD MCKEES ROCKS PA 15136 ALLEGHENY 4127776161 390160 CANONSBURG GENERAL HOSPITAL 100 MEDICAL BOULEVARD CANONSBURG PA 15317 WASHINGTON 7248735892 390162 EASTON HOSPITAL 250 SOUTH 21ST STREET EASTON PA 18042 NORTHAMPTON 6102504076 390163 ACMH HOSPITAL ONE NOLTE DRIVE KITTANNING PA 16201 ARMSTRONG 7245438500 390164 UPMC PRESBYTERIAN SHADYSIDE 200 LOTHROP STREET PITTSBURGH PA 15213 ALLEGHENY 4126478788 390168 BUTLER MEMORIAL HOSPITAL ONE HOSPITAL WAY BUTLER PA 16001 BUTLER 7242836666 390173 INDIANA REGIONAL MEDICAL CENTER 835 HOSPITAL ROAD INDIANA PA 15701 INDIANA 7243577000 390174 THOMAS JEFFERSON UNIVERSITY HOSPITAL 111 SOUTH 11TH STREET PHILADELPHIA PA 19107 2159556000 390178 UPMC HORIZON 110 NORTH MAIN STREET GREENVILLE PA 16125 MERCER 7245882100 390179 CHESTER COUNTY HOSPITAL 701 EAST MARSHALL STREET WEST CHESTER PA 19380 CHESTER 6104315000 390180 CROZER CHESTER MEDICAL CENTER ONE MEDICAL CENTER BOULEVARD UPLAND PA 19013 DELAWARE 6104472000 390183 ST LUKE'S MINERS MEMORIAL HOSPITAL 360 W RUDDLE STREET COALDALE PA 18218 SCHUYLKILL 5706452131 390184 HIGHLANDS HOSPITAL 401 EAST MURPHY AVENUE CONNELLSVILLE PA 15425 FAYETTE 7246281500 390185 LEHIGH VALLEY HOSPITAL ‐ HAZLETON 700 EAST BROAD STREET HAZLETON PA 18201 LUZERNE 5705014000 390192 TYLER MEMORIAL HOSPITAL 5950 STATE ROUTE 6 WEST TUNKHANNOCK PA 18657 WYOMING 5708362161 390194 BLUE MOUNTAIN HOSPITAL‐GNADEN HUETTEN CAMPUS 211 NORTH 12TH STREET LEHIGHTON PA 18235 CARBON 6073771300
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 175 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 390195 MAIN LINE HOSPITAL LANKENAU 100 LANCASTER AVE WYNNEWOOD PA 19096 MONTGOMERY 6106452000 390196 HOSPITAL OF THE FOX CHASE CANCER CENTER 333 COTTMAN AVENUE PHILADELPHIA PA 19111 2157282660 390197 SACRED HEART HOSPITAL 421 CHEW STREET ALLENTOWN PA 18102 LEHIGH 6107764900 390198 MILLCREEK COMMUNITY HOSPITAL 5515 PEACH STREET ERIE PA 16509 ERIE 8148644031 390199 PUNXSUTAWNEY AREA HOSPITAL 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 JEFFERSON 8149381800 390201 POCONO MEDICAL CENTER 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 MONROE 5704763348 390203 DOYLESTOWN HOSPITAL 595 WEST STATE ST DOYLESTOWN PA 18901 BUCKS 2153452200 390204 NAZARETH HOSPITAL 2601 HOLME AVE PHILADELPHIA PA 19152 2153356000 390211 SHARON REGIONAL HEALTH SYSTEM 740 EAST STATE STREET SHARON PA 16146 MERCER 7249833800 390217 EXCELA HEALTH FRICK HOSPITAL 508 SOUTH CHURCH STREET MOUNT PLEASANT PA 15666 WESTMORELAND 7245471500 390219 EXCELA HEALTH LATROBE HOSPITAL ONE MELLON WAY LATROBE PA 15650 WESTMORELAND 7245371000 390220 JENNERSVILLE REGIONAL HOSPITAL 1015 WEST BALTIMORE PIKE WEST GROVE PA 19390 CHESTER 6108691000 390222 RIDDLE MEMORIAL HOSPITAL 1068 WEST BALTIMORE PIKE MEDIA PA 19063 DELAWARE 6105669400 390223 PENN PRESBYTERIAN MEDICAL CENTER 51 NORTH 39TH STREET PHILADELPHIA PA 19104 2156628000 390225 EPHRATA COMMUNITY HOSPITAL 169 MARTIN AVENUE EPHRATA PA 17522 LANCASTER 7177330311 390226 PENNSYLVANIA HOSPITAL 800 SPRUCE STREET PHILADELPHIA PA 19107 2158293000 390228 ST CLAIR HOSPITAL 1000 BOWER HILL ROAD PITTSBURGH PA 15243 ALLEGHENY 4129424000 390231 ABINGTON MEMORIAL HOSPITAL 1200 OLD YORK ROAD ABINGTON PA 19001 MONTGOMERY 2154812000 390233 HANOVER HOSPITAL 300 HIGHLAND AVE HANOVER PA 17331 YORK 7176373711 390236 GUTHRIE TOWANDA MEMORIAL HOSPITAL 91 HOSPITAL DRIVE TOWANDA PA 18848 BRADFORD 5702652191 390237 REGIONAL HOSPITAL OF SCRANTON 746 JEFFERSON AVENUE SCRANTON PA 18501 LACKAWANNA 5703487100 390256 MILTON S HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY PA 17033 DAUPHIN 7175318521 390258 ST MARY MEDICAL CENTER LANGHORNE‐NEWTOWN RD LANGHORNE PA 19047 BUCKS 2157502003 390263 LEHIGH VALLEY HOSPITAL ‐ MUHLENBERG 2545 SCHOENERSVILLE ROAD BETHLEHEM PA 18017 LEHIGH 6104022273 390265 JEFFERSON HOSPITAL 565 COAL VALLEY ROAD JEFFERSON HILLS PA 15025 ALLEGHENY 4124695000 390266 GROVE CITY MEDICAL CENTER 631 NORTH BROAD STREET EXT. GROVE CITY PA 16127 MERCER 7244507000 390267 FORBES HOSPITAL 2570 HAYMAKER ROAD MONROEVILLE PA 15146 ALLEGHENY 4128582000 390268 MOUNT NITTANY MEDICAL CENTER 1800 EAST PARK AVE STATE COLLEGE PA 16803 CENTRE 8142317000 390270 GEISINGER WYOMING VALLEY MEDICAL CENTER 1000 EAST MOUNTAIN BOULEVARD WILKES BARRE PA 18711 LUZERNE 5708267300 390272 VALLEY FORGE MEDICAL CENTER AND HOSPITAL 1033 W GERMANTOWN PIKE NORRISTOWN PA 19401 MONTGOMERY 2155398500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 176 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 390278 EAGLEVILLE HOSPITAL 100 EAGLEVILLE RD EAGLEVILLE PA 19408 MONTGOMERY 2155396000 390290 HAHNEMANN UNIVERSITY HOSPITAL 230 NORTH BROAD STREET PHILADELPHIA PA 19102 2157627000 390302 BARIX CLINICS OF PENNSYLVANIA 280 MIDDLETOWN ROAD LANGHORNE PA 19047 BUCKS 2675723100 390304 ROXBOROUGH MEMORIAL HOSPITAL 5800 RIDGE AVE PHILADELPHIA PA 19128 2154839900 390307 EDGEWOOD SURGICAL HOSPITAL 239 EDGEWOOD DRIVE EXTENSION TRANSFER PA 16154 MERCER 7246460400 390312 CANCER TREATMENT CENTERS OF AMERICA 1331 EAST WYOMING AVENUE PHILADELPHIA PA 19124 2157446728 390314 COORDINATED HEALTH ORTHOPEDIC HOSPITAL 2310 HIGHLAND AVENUE BETHLEHEM PA 18017 LEHIGH 6106914300 390316 SURGICAL INSTITUTE OF READING 2752 CENTURY BOULEVARD WYOMISSING PA 19610 BERKS 7179999999 390321 SURGICAL SPECIALTY CENTER AT COORDINATED HEALTH 1503 CEDAR CREST BOULEVARD ALLENTOWN PA 18104 LEHIGH 6108719110
390322 ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL LLC 3300 TILLMAN DRIVE BENSALEM PA 19020 BUCKS 2152447400 390323 ADVANCED SURGICAL HOSPITAL 100 TRICH DRIVE WASHINGTON PA 15301 WASHINGTON 7248840710 390324 PHYSICIAN'S CARE SURGICAL HOSPITAL 454 ENTERPRISE DRIVE ROYERSFORD PA 19468 MONTGOMERY 6104954793 390325 OSS ORTHOPAEDIC HOSPITAL 1861 POWDER MILL RD YORK PA 17402 YORK 7177182000 390326 ST LUKE'S HOSPITAL ‐ ANDERSON CAMPUS 1872 RIVERSIDE CIRCLE EASTON PA 18045 NORTHAMPTON 6109543850 390327 WELLSPAN SURGERY AND REHABILITATION HOSPITAL 55 MONUMENT ROAD YORK PA 17403 YORK 7178126100
390328 UPMC EAST 2775 MOSSIDE BOULEVARD MONROEVILLE PA 15146 ALLEGHENY 4123573000 390329 EINSTEIN MEDICAL CENTER MONTGOMERY 559 WEST GERMANTOWN PIKE EAST NORRITON PA 19403 MONTGOMERY 4846621000 391300 JERSEY SHORE HOSPITAL 1020 THOMPSON STREET JERSEY SHORE PA 17740 LYCOMING 5703980100 391301 MUNCY VALLEY HOSPITAL 215 EAST WATER STREET MUNCY PA 17756 LYCOMING 5705468282 391302 MEYERSDALE MEDICAL CENTER 200 HOSPITAL DRIVE MYERSDALE PA 15552 SOMERSET 8146345911 391303 FULTON COUNTY MEDICAL CENTER 214 PEACH ORCHARD ROAD MCCONNELLSBURG PA 17233 FULTON 7174853155 391304 BUCKTAIL MEDICAL CENTER 1001 PINE STREET RENOVO PA 17764 CLINTON 5709231000 391305 TROY COMMUNITY HOSPITAL 275 GUTHRIE DRIVE TROY PA 16947 BRADFORD 5702972121 391306 ENDLESS MOUNTAINS HEALTH SYSTEMS 100 HOSPITAL DRIVE MONTROSE PA 18801 SUSQUEHANNA 5702783801 391307 TYRONE HOSPITAL 187 HOSPITAL DRIVE TYRONE PA 16686 BLAIR 8146841255 391308 CORRY MEMORIAL HOSPITAL 965 SHAMROCK LANE CORRY PA 16407 ERIE 8146644641 391309 BARNES‐KASSON COUNTY HOSPITAL 2872 TURNPIKE STREET SUSQUEHANNA PA 18847 SUSQUEHANNA 5708533135 391312 PENN HIGHLANDS BROOKVILLE 100 HOSPITAL ROAD BROOKVILLE PA 15825 JEFFERSON 8148492312 391313 CHARLES COLE MEMORIAL HOSPITAL 1001 EAST SECOND STREET COUDERSPORT PA 16915 POTTER 8142749301
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 177 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 391314 TITUSVILLE HOSPITAL 406 WEST OAK STREET TITUSVILLE PA 16354 CRAWFORD 8148271851 391315 PENN HIGHLANDS ELK 763 JOHNSONBURG ROAD SAINT MARYS PA 15857 ELK 8147888000 392024 LIFECARE HOSPITALS OF PITTSBURGH 225 PENN AVENUE PITTSBURGH PA 15221 ALLEGHENY 4122472356 392025 PAM SPECIALTY HOSPITAL OF WILKES‐BARRE 275 NORTH RIVER ST WILKES‐BARRE PA 18702 LUZERNE 5702083310 392027 KINDRED HOSPITAL PHILADELPHIA 6129 PALMETTO STREET LAWNCREST PA 19111 2157228555 392028 KINDRED HOSPITAL ‐ PITTSBURGH 7777 STEUBENVILLE PIKE OAKDALE PA 15071 ALLEGHENY 4124945500 392031 SELECT SPECIALTY HOSPITAL ‐ JOHNSTOWN 320 MAIN STREET JOHNSTOWN PA 15901 CAMBRIA 8145347300 392033 GOOD SHEPHERD SPECIALTY HOSPITAL 2545 SCHOENERSVILLE ROAD BETHLEHEM PA 18017 LEHIGH 4848845051 392036 SELECT SPECIALTY HOSPITAL LAUREL HIGHLANDS INC ONE MELLON WAY LATROBE PA 15650 WESTMORELAND 7248308649
392037 SELECT SPECIALTY HOSPITAL ‐ ERIE 252 WEST 11TH STREET ERIE PA 16501 ERIE 8148745300 392038 LIFECARE HOSPITALS OF MECHANICSBURG 4950 WILSON LANE MECHANICSBURG PA 17055 CUMBERLAND 7177908540 392039 SELECT SPECIALTY HOSPITAL ‐ CENTRAL PA (CAMP HILL) 503 NORTH 21ST STREET, FIFTH FLOOR CAMP HILL PA 17011 CUMBERLAND 7179724560
392041 LIFECARE HOSPITALS OF PITTSBURGH‐ MONROEVILLE 2380 MCGINLEY ROAD MONROEVILLE PA 15146 ALLEGHENY 4128562400
392043 KINDRED HOSPITAL AT HERITAGE VALLEY 1000 DUTCH RIDGE ROAD BEAVER PA 15009 BEAVER 7247738480 392044 SELECT SPECIALTY HOSPITAL ‐ PITTSBURGH/UPMC 200 LOTHROP STREET, MUH E824 PITTSBURGH PA 15213 ALLEGHENY 4125869821 392045 SELECT SPECIALTY HOSPITAL ‐ MCKEESPORT, INC 1500 FIFTH AVENUE MC KEESPORT PA 15132 ALLEGHENY 4126642900 392046 KINDRED HOSPITAL SOUTH PHILADELPHIA 1930 SOUTH BROAD STREET UNIT #12 PHILADELPHIA PA 19145 2675705200 392047 SELECT SPECIALTY HOSPITAL ‐ DANVILLE 100 NORTH ACADEMY AVENUE 3RD FLR BUSH & GEISINGER DANVILLE PA 17822 MONTOUR 5702149648
392048 LIFECARE HOSPITALS OF CHESTER COUNTY 400 EAST MARSHAL STREET WEST CHESTER PA 19380 CHESTER 4848260400 392050 GOOD SHEPHERD PENN PARTNERS 1800 LOMBARD STREET PHILADELPHIA PA 19146 2158932548 393025 BRYN MAWR REHABILITATION HOSPITAL 414 PAOLI PIKE MALVERN PA 19355 CHESTER 6102515400 393026 HEALTHSOUTH READING REHABILITATION HOSPITAL 1623 MORGANTOWN ROAD READING PA 19607 BERKS 6107966000 393027 HEALTHSOUTH HARMARVILLE REHABILITATION HOSPITAL 320 GUYS RUN ROAD PITTSBURGH PA 15238 ALLEGHENY 4128281300
393030 ALLIED SERVICES INSTITUTE OF REHABILITATI MEDICINE 475 MORGAN HIGHWAY SCRANTON PA 18508 LACKAWANNA 5703481367
393031 HEALTHSOUTH REHAB HOSPITAL OF MECHANICSBURG 175 LANCASTER BOULEVARD MECHANICSBURG PA 17055 CUMBERLAND 7176913720
393035 GOOD SHEPHERD REHABILITATION HOSPITAL, THE 850 SOUTH FIFTH STREET ALLENTOWN PA 18103 LEHIGH 6107763223
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 178 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 393036 JOHN HEINZ INSTITUTE OF REHABILITATION 150 MUNDY STREET WILKES BARRE TOWNSHI PA 18702 LUZERNE 5708263800 393037 HEALTHSOUTH REHABILITATION HOSPITAL OF YORK 1850 NORMANDIE DRIVE YORK PA 17404 YORK 7177676941 393038 MAGEE REHABILITATION HOSPITAL SIX FRANKLIN PLAZA PHILADELPHIA PA 19102 2155873034 393039 HEALTHSOUTH NITTANY VALLEY REHABILITATION 550 WEST COLLEGE AVENUE PLEASANT GAP PA 16823 CENTRE 8143593421 HOSPITAL 393040 HEALTHSOUTH REHAB HOSP OF ALTOONA 2005 VALLEY VIEW BOULEVARD ALTOONA PA 16602 BLAIR 8149443535 393045 HEALTHSOUTH REHABILITATION HOSPITAL OF SEWICKLEY 303 CAMP MEETING ROAD SEWICKLEY PA 15143 ALLEGHENY 4127419500
393046 HEALTHSOUTH REHABILITATION HOSPITAL OF ERIE 143 EAST SECOND STREET ERIE PA 16507 ERIE 8148781200 393047 GEISINGER HEALTHSOUTH REHABILITATION HOSPITAL 2 REHAB LANE DANVILLE PA 17821 MONTOUR 5702716110
393053 PENN STATE HERSHEY REHABILITATION, LLC 1135 OLD WEST CHOCOLATE AVE HUMMELSTOWN PA 17036 DAUPHIN 7178322600 393054 LANCASTER REHABILITATION HOSPITAL 675 GOOD DRIVE LANCASTER PA 17604 LANCASTER 7175444819 393055 ST MARY REHABILITATION HOSPITAL 1208 LANGHORNE‐NEWTOWN ROAD LANGHORNE PA 19047 BUCKS 2676880711 393056 HELEN M SIMPSON REHABILITATION HOSPITAL 4300 LONDONDERRY ROAD HARRISBURG PA 17109 DAUPHIN 7179204300 393302 CHILDREN'S HOSPITAL OF PITTSBURGH OF UPMC 4401 PENN AVENUE PITTSBURGH PA 15224 ALLEGHENY 4126925325 393303 CHILDREN'S HOSPITAL OF PHILADELPHIA 34TH ST & CIVIC CENTER BLVD PHILADELPHIA PA 19104 2155903745 393304 CHILDREN'S HOME OF PITTSBURGH 5324 PENN AVENUE PITTSBURGH PA 15224 ALLEGHENY 4124414884 393307 ST CHRISTOPHER'S HOSPITAL FOR CHILDREN 120 EAST ERIE AVE PHILADELPHIA PA 19133 2154275000 393308 CHILDREN'S INSTITUTE OF PITTSBURGH, THE 6301 NORTHUMBERLAND STREET PITTSBURGH PA 15217 ALLEGHENY 4124202400 393309 SHRINERS HOSPITALS FOR CHILDREN ‐ PHILADELPHIA 3551 N BROAD STREET PHILADELPHIA PA 19104 2154304000
394001 NORRISTOWN STATE HOSPITAL 1001 STERIGERE STREET NORRISTOWN PA 19401 MONTGOMERY 6103131000 394004 DANVILLE STATE HOSPITAL 200 STATE HOSPITAL DRIVE DANVILLE PA 17821 MONTOUR 5702714500 394007 KIRKBRIDE CENTER 111 N 49TH ST PHILADELPHIA PA 19139 2154712358 394008 FRIENDS HOSPITAL 4641 ROOSEVELT BOULEVARD PHILADELPHIA PA 19124 2158314600 394012 CLARKS SUMMIT STATE HOSPITAL 1451 HILLSIDE DRIVE CLARKS SUMMIT PA 18411 LACKAWANNA 5705862011 394014 WERNERSVILLE STATE HOSPITAL 160 MAIN STREET WERNERSVILLE PA 19565 BERKS 6106704100 394016 WARREN STATE HOSPITAL 33 MAIN DRIVE NORTH WARREN PA 16365 WARREN 8147235500 394020 PHILHAVEN HOSPITAL 283 SOUTH BUTLER ROAD MT GRETNA PA 17064 LEBANON 7172738871 394023 BELMONT CENTER FOR COMPREHENSIVE TREATMENT 4200 MONUMENT AVENUE PHILADELPHIA PA 19131 2158772000 394026 TORRANCE STATE HOSPITAL 121 LONGVIEW DRIVE TORRANCE PA 15779 WESTMORELAND 7244598000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 179 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 394027 FAIRMOUNT BEHAVIORAL HEALTH SYSTEM 561 FAIRTHORNE AVENUE PHILADELPHIA PA 19128 2154874000 394033 MONTGOMERY COUNTY EMERGENCY SERVICE, INC 50 BEECH DRIVE NORRISTOWN PA 19403 MONTGOMERY 6102796100 394034 HORSHAM CLINIC 722 EAST BUTLER PIKE AMBLER PA 19002 MONTGOMERY 2156437800 394038 FOUNDATIONS BEHAVIORAL HEALTH 833 EAST BUTLER AVE DOYLESTOWN PA 18901 BUCKS 2153450444 394039 FIRST HOSPITAL OF WYOMING VALLEY 562 WYOMING AVENUE KINGSTON PA 18704 LUZERNE 5705523900 394040 MEADOWS PSYCHIATRIC CENTER 132 MEADOWS DRIVE CENTRE HALL PA 16828 CENTRE 8143642161 394043 CLARION PSYCHIATRIC CENTER TWO HOSPITAL DR RD#3 BOX 188 CLARION PA 16214 CLARION 8142269545 394047 KIDSPEACE ORCHARD HILLS CAMPUS 5300 KIDSPEACE DRIVE OREFIELD PA 18069 LEHIGH 6107998800 394048 DIVINE PROVIDENCE HOSPITAL 1100 GRAMPIAN BOULEVARD WILLIAMSPORT PA 17701 LYCOMING 5703268000 394049 BROOKE GLEN BEHAVIORAL HOSPITAL 7170 LAFAYETTE AVENUE FORT WASHINGTON PA 19034 MONTGOMERY 2156415300 394050 ROXBURY TREATMENT CENTER 601 ROXBURY ROAD SHIPPENSBURG PA 17257 CUMBERLAND 7175324217 394051 PENNSYLVANIA PSYCHIATRIC INSTITUTE 2501 NORTH THIRD STREET HARRISBURG PA 17110 DAUPHIN 7177824742 394052 HAVEN BEHAVIORAL HOSPITAL OF EASTERN 145 NORTH 6TH STREET READING PA 19601 BERKS 6104064340 PENNSYLVANIA 394053 HAVEN BEHAVIORAL HOSPITAL OF PHILADELPHIA 3300 HENRY AVENUE UNIT 4 PHILADELPHIA PA 19129 2154753400 394054 LIFECARE BEHAVIORAL HEALTH HOSPITAL 225 PENN AVENUE 2ND FLOOR PITTSBURGH PA 15221 ALLEGHENY 4122472000 399800 GEISINGER MEDICAL CENTER ‐ TRANSPLANT CENTER 100 NORTH ACADEMY AVENUE DANVILLE PA 17822 MONTOUR 5702716211 399801 UPMC PRESBYTERIAN SHADYSIDE 200 LOTHROP STREET PITTSBURGH PA 15213 ALLEGHENY 4126478788 399803 CHILDRENS HOSPITAL OF PITTSBURGH TRANSPLANT 4401 PENN AVENUE PITTSBURGH PA 15224 ALLEGHENY 4126925325 CENTER 399804 ALLEGHENY GENERAL HOSPITAL TRANSPLANT CARE 320 EAST NORTH AVENUE PITTSBURGH PA 15212 ALLEGHENY 4123593131 399805 HAHNEMANN UNIVERSITY HOSPITAL TRANSPLANT CENTER BROAD AND VINE STREETS PHILADELPHIA PA 19102 2157627167
399806 TEMPLE UNIVERSITY HOSPITAL ‐ TRANSPLANT CENTER 3401 NORTH BROAD STREET PHILADELPHIA PA 19140 2157072000
399807 MILTON S HERSHEY MEDICAL CENTER TRANSPLANT CENTER 500 UNIVERSITY DRIVE HERSHEY PA 17033 DAUPHIN 7175318521
399808 HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA 3400 SPRUCE STREET PHILADELPHIA PA 19104 2156623227 399809 PINNACLE HEALTH HOSPITALS TRANSPLANT CENTER 409 SOUTH SECOND STREET HARRISBURG PA 17105 DAUPHIN 7177825181 399810 THOMAS JEFFERSON UNIVERSITY HOSPITAL TRANSPLANT 111 SOUTH 11TH STREET PHILADELPHIA PA 19107 2159557022
399811 MAIN LINE HOSPITAL LANKENAU TRANSPLANT CENTER 100 LANCASTER AVENUE WYNNEWOOD PA 19096 MONTGOMERY 6106452000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 180 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 399812 CHILDREN'S HOSPITAL OF PHILADELPHIA TRANSPLANT 34TH STREET AND CIVIC CENTER BLVD PHILADELPHIA PA 19104 2674266922
399813 ALBERT EINSTEIN MEDICAL CENTER TRANSPLANT CENTER 5501 OLD YORK ROAD PHILADELPHIA PA 19141 2154567010
399815 LEHIGH VALLEY HOSPITAL ‐ TRANSPLANT CENTER 1200 SOUTH CEDAR CREST BOULEVARD, PO BOX 689 ALLENTOWN PA 18105 LEHIGH 6104022273 399816 CROZER CHESTER MEDICAL CENTER ‐ TRANSPLANT CENTER ONE MEDICAL CENTER BOULEVARD UPLAND PA 19013 DELAWARE 6104472000
400001 PRESBYTERIAN COMMUNITY HOSP 1451 ASHFORD AVENUE SAN JUAN PR 00907 7877212160 400003 HOSPITAL METROPOLITANO DR PILA 2435 LAS AMERICAS AVE PONCE PR 00733 7878485600 400004 ASOCIACION HOSPITAL DEL MAESTRO, INC SERGIO CUEVAS BUSTAMANTE STREET 550 SAN JUAN PR 00936 7877586420 400005 HIMA SAN PABLO HUMACAO CALLE FONT MARTELO #3 HUMACAO PR 00791 7878522424 400006 DOCTORS' CENTER HOSPITAL SAN JUAN PDA. 20 C/ SAN RAFAEL # 1395 FERNANDEZ JUNCOS PR 00909 7877232950 400007 RYDER MEMORIAL HOSPITAL INC 355 AVE FONT MARTELO HUMACAO PR 00791 7878520768 400009 SANTA ROSA CLINIC AVE. LOS VETERANOS #3 KM 135 7 EXIT TO ARROYO GUAYAMA PR 00785 7878640101 400010 HOSPITAL GENERAL DE CASTANER CARR 135 KM 64 2 CASTANER PR 00631 7878295010 400011 HOSPITAL ORIENTE 300 FONT MARTELLO STREET HUMACAO PR 00792 7878520505 400012 HOSPITAL ONCOLOGICO DR ISAAC GONZALEZ MARTINEZ BO. MONACILLOS CARR 22 CENTRO MEDICO DE PUERTO SAN JUAN PR 00935 7877634149 RIC 400013 HOSPITAL MENONITA DE CAYEY BO. RINCON SECTOR LAS LOMAS KM.3.1 CARR 14 CAYEY PR 00737 7875351001 400014 BELLA VISTA HOSPITAL CARR 349 KM 2 7 CERRO LAS MESAS MAYAGUEZ PR 00681 7876526045 400015 SAN JUAN MUNICIPAL HOSPITAL BARRIO MONACILLOS,CENTRO MEDICO RIO PIEDRAS PR 00936 7877568535 400016 AUXILIO MUTUO HOSPITAL PONCE DE LEON AVENUE STOP 36 1/2 #735 HATO REY PR 00918 7877582000 400018 MENNONITE GENERAL HOSPITAL INC CALLE JOSE C VASQUEZ BO. CAONILLAS AIBONITO PR 00705 7875351001 400019 HOSPITAL PAVIA SANTURCE CALLE PROFESOR AUGUSTO RODRIGUEZ #1462 FERNANDEZ JUNCOS PR 00910 7877276060 400021 HOSPITAL DE LA CONCEPCION ROAD NUMBER 2 KM 173.4 CAIN ALTO SAN GERMAN PR 00683 7878921860 400022 HOSPITAL DAMAS INC PONCE BY PASS #2213 PONCE PR 00717 7878408460 400026 LAFAYETTE HOSPITAL CARR.753 KM.0.1‐SECTOR CUATRO CALLES ARROYO PR 00714 7878393232 400032 HOSPITAL HERMANOS MELENDEZ INC CARRETERA #2 KM 11 7 BAYAMON PR 00960 7876208181 40003F VA HOSP #10 CASIA STREET SAN JUAN PR 00921 7876417582 400044 SAN LUKE'S MEMORIAL HOSPITAL INC TITO CASTRO AVE #917 PONCE PR 00733 7878442080 400048 HOSPITAL EPISCOPAL SAN LUCAS GUAYAMA INC AVE. PEDRO ALBIZU CAMPOS URB. LA HACIENDA GUAYAMA PR 00785 7878644300 400061 HOSPITAL UNIVERSITARIO DE ADULTO BARRIO MONACILLOS CENTROMEDICO RIO PIEDRAS PR 00927 7877540101
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 181 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 400079 HOSP COMUNITARIO BUEN SAMARITANO CARR.2 KM.1.4 AVE. SEVERIANO CUEVAS #18 AGUADILLA PR 00603 7876580000 400087 HOSPITAL DR CAYETANO COLL Y TOSTE CARRETERA 129 KM.1 AVENIDA SAN LUIS ARECIBO PR 00613 7876507272 400098 HOSPITAL SAN FRANCISCO 371 DE DIEGO AVE SAN JUAN PR 00923 7877675100 400102 DOCTORS CENTER HOSPITAL BAYAMON 9 J STREET EXT HERMANAS DAVILA BAYAMON PR 00959 7876225420 400103 MAYAGUEZ MEDICAL CENTER DR RAMON EMETERIO CARR 2 BO SABALOS MAYAGUEZ PR 00682 7876529200 BETANCES 400104 HOSPITAL MENONITA CAGUAS INC CARR 172 EXIT 21 URB TURABO GARDENS CAGUAS PR 00725 7877443141 400105 HOSPITAL UNIVERSITARIO DR RUIZ ARNAU LAUREL AVE SANTA JUANITA #100 BAYAMON PR 00956 7877875151 400106 METROPOLITAN HOSPITAL CARRETERA 21 1785 URB LAS LOMAS SAN JUAN PR 00915 7877829999 400109 HIMA SAN PABLO BAYAMON CALLE SANTA CRUZ NUMERO 70 URB SANTA CRUZ BAYAMON PR 00961 7876204747 400110 HOSPITAL METROPOLITANO DR TITO MATTEI ROAD 128 KM 1.0 YAUCO PR 00698 7878561000 400111 HOSPITAL SAN CARLOS BORROMEO CALLE CONCEPCION VERA AYALA #550 S MOCA PR 00676 7878778000 400112 HOSPITAL UPR, DR FEDERICO TRILLA CARR 3 KM 8 3 AVE 65TH INFANTERIA BOX 6021 CAROLINA PR 00984 7877571800 400113 HOSPITAL SAN CRISTOBAL CARR 506 KM 1 0COTO LAUREL PR 00780 7878482100 400114 MANATI MEDICAL CENTER DR OTERO LOPEZ CALLE HERNANDEZ CARRION URB ATENAS MANATI PR 00674 7876213700 400115 CENTRO MEDICO WILMA N VAZQUEZ CARR. 2 KM 39.5 ROAD NUMBER 2 BO ALGARROBO VEGA BAJA PR 00693 7878581580 400117 HOSPITAL DR SUSONI INC 55 PALM ST ARECIBO PR 00614 7876501031 400118 DOCTORS' CENTER HOSPITAL, INC MARGINAL CARRETERA NO 2, KM 47 7 MANATI PR 00674 7878533322 400120 HIMA SAN PABLO‐CAGUAS AVE LUIS MUNOZ MARIN CAGUAS PR 00725 7876533434 400121 HOSPITAL SAN GERARDO CARR 844 KM 0 5 CUPEY BAJO SAN JUAN PR 00928 7877618383 400122 PROFESSIONAL HOSPITAL GUAYNABO INC AVE LAS CUMBRES ST 199KM 1 2ALT DE SANTA PR 00969 7877086560 400123 HOSPITAL PEREA 15 DR BASORA STREET MAYAGUEZ PR 00681 7878340101 400124 CENTRO CARDIOVASCULAR AVENIDA AMERICO MIRANDA, ENTRADA PRINCIPAL CM RIO PIEDRAS PR 00936 7877548500
400125 HIMA‐SAN PABLO FAJARDO GENERAL VALERO AVE#404 FAJARDO PR 00738 7876550505 400126 HOSPITAL METROPOLITANO SAN GERMAN CALLE JAVILLA #8 AL COSTADO PARQUE DE BOMBAS SAN GERMAN PR 00683 7878925300 400127 ADMIN DE SERVICIOS MEDICOS PUERTO RIC BO MONACILLO CARR NUM 22 SAN JUAN PR 00935 7877773535 400128 HOSPITAL PAVIA HATO REY, INC AVE PONCE DE LEON 435 HATO REY PR 00919 7877540909 400130 HOSPITAL METROPOLITANO DE LA MONTANA CALLE ISAAC GONZALEZ ESQUINA LEDESMA BDA NUEVA PR 00641 7879331100 400131 CARIBBEAN MEDICAL CENTER 151 AVE OSVALDO MOLINA FAJARDO PR 00738 7878010081 40015E EL BUEN PASTOR ARECIBO PR 00612
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 182 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 40024E REHABILITATION CENTER BO MONACILLOS RIO PIEDRAS PR 00928 403025 HEALTH SOUTH REHABILITATION HOSPITAL OF SAN JUAN UNIVERSITY DISTRICT HOSPITAL ‐‐ 3RD FLOOR SAN JUAN PR 00936 7872745100
403026 HEALTHSOUTH REHABILITATION HOSPITAL OF MANATI, INC CARR 2 K47 7ALTS DE MANATI PR 00674 7876213800
403027 MULTY MEDICAL FACILITIES CORPORATION MUNOZ RIVERA AVENUE 402 SAN JUAN PR 00918 7877058677 403301 UNIVERSITY PEDIATRIC HOSPITAL PUERTO RICO MEDICAL CENTER IN RIO PIEDRAS SAN JUAN PR 00935 7877773232 404004 FIRST HOSPITAL PANAMERICANO STATE ROAD 787 KM 1 5 CIDRA PR 00739 7877395555 404005 SAN JUAN CAPESTRANO PSYCIATRIC HOSPITAL CARR 877 KM 1 6 CAMINO LAS LOMAS RR2 RIO PIEDRAS PR 00928 7877652900 404007 HOSPITAL PSIQUIATRICO METROPOLITANO CABO ROJO 108 MUNOZ RIVERA STREET BO BALLAJA PR 00623 7878512025
404008 INSPIRA BEHAVIOR CARE CORP CALLE GUADALUPE 184 (ANTIGUO HOSPITAL SAN LUCAS) PONCE PR 00733 7877094130
404009 CENTRO DE SALUD CONDUCTUAL MENONITA‐CIMA CARR ESTATAL 14 INTERIOR SARGENTO GERARDO AIBONITO PR 00705 7877142462 SANTIAGO 409800 AUXILIO MUTUO HOSP TRANSPLANT PONCE DE LEON AVE, STOP 375 HATO REY PR 00917 7877717382 410001 MEMORIAL HOSPITAL OF RHODE ISLAND 111 BREWSTER STREET PAWTUCKET RI 02860 4017292000 410004 ROGER WILLIAMS MEDICAL CENTER 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 4014562025 410005 OUR LADY OF FATIMA HOSPITAL 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 4014563000 410006 NEWPORT HOSPITAL FRIENDSHIP STREET NEWPORT RI 02840 4018466400 410007 RHODE ISLAND HOSPITAL 593 EDDY STREET PROVIDENCE RI 02903 4014444000 410008 SOUTH COUNTY HOSPITAL INC 100 KENYON AVE WAKEFIELD RI 02879 4017828000 410009 KENT COUNTY MEMORIAL HOSPITAL 455 TOLL GATE RD WARWICK RI 02886 4017377000 410010 WOMEN AND INFANTS HOSPITAL OF RHODE ISLAND 101 DUDLEY STREET PROVIDENCE RI 02905 4012741100 410011 LANDMARK MEDICAL CENTER, INC 115 CASS AVE WOONSOCKET RI 02895 4017694100 410012 MIRIAM HOSPITAL 164 SUMMIT AVENUE PROVIDENCE RI 02906 4017932500 410013 WESTERLY HOSPITAL 25 WELLS STREET WESTERLY RI 02891 4015966000 41001F US NAVAL HOSP CYPRESS + 3RD STS NEWPORT RI 02840 41002F VA HOSP DAVIS PARK DR PROVIDENCE RI 02908 41004F US NAVAL HOSP QUONSET POINT RI 02819 41005F VETERANS AFFAIRS MEDICAL CENTER 830 CHALKSTONE AVENUE PROVIDENCE RI 02908 4014573042 412001 ELEANOR SLATER HOSPITAL 111 HOWARD AVE CRANSTON RI 02921 4014621525
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 183 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 413025 REHABILITATION HOSPITAL OF RHODE ISLAND 116 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD RI 02896 4017660800 414000 BUTLER HOSPITAL 345 BLACKSTONE BLVD PROVIDENCE RI 02906 4014556270 414003 EMMA PENDLETON BRADLEY HOSPITAL 1011 VETERANS MEMORIAL PARKWAY EAST PROVIDENCE RI 02915 4014343400 419801 RHODE ISLAND HOSPITAL ‐ TRANSPLANT CENTER 593 EDDY STREET PROVIDENCE RI 02905 4014444000 420002 PIEDMONT MEDICAL CENTER 222 S HERLONG AVE ROCK HILL SC 29730 YORK 8033291234 420004 MUSC MEDICAL CENTER 169 ASHLEY AVE CHARLESTON SC 29425 CHARLESTON 8437922300 420005 MCLEOD MEDICAL CENTER ‐ DILLON 301 E JACKSON STREET PO BOX 1327 DILLON SC 29536 DILLON 8437744111 420007 SPARTANBURG MEDICAL CENTER 101 E WOOD ST SPARTANBURG SC 29303 SPARTANBURG 8645606000 420009 GHS OCONEE MEMORIAL HOSPITAL 298 MEMORIAL DRIVE SENECA SC 29672 OCONEE 8644823100 420010 CAROLINA PINES REGIONAL MEDICAL CENTER 1304 W BOBO NEWSOM HWY HARTSVILLE SC 29550 DARLINGTON 8643392100 420011 CANNON MEMORIAL HOSPITAL 123 MEDICAL PARK DRIVE PO BOX 188 PICKENS SC 29671 PICKENS 8648784791 420015 BAPTIST EASLEY HOSPITAL PO BOX 2129 EASLEY SC 29641 PICKENS 8644427200 420018 PALMETTO HEALTH RICHLAND 5 RICHLAND MEDICAL PARK COLUMBIA SC 29203 RICHLAND 8032965678 420019 CHESTER REGIONAL MEDICAL CENTER 1 MEDICAL PARK DRIVE CHESTER SC 29706 CHESTER 8035813151 420020 GEORGETOWN MEMORIAL HOSPITAL 606 BLACK RIVER RD DRAWER 1718 GEORGETOWN SC 29440 GEORGETOWN 8435277000 420023 ST FRANCIS‐DOWNTOWN ONE ST FRANCIS DR GREENVILLE SC 29601 GREENVILLE 8008055678 420026 PROVIDENCE HOSPITAL 2435 FOREST DR COLUMBIA SC 29204 RICHLAND 8032565300 420027 ANMED HEALTH 800 N FANT ST ANDERSON SC 29621 ANDERSON 8642611109 420030 COLLETON MEDICAL CENTER 501 ROBERTSON BOULEVARD WALTERBORO SC 29488 COLLETON 8437822000 420033 GHS GREER MEMORIAL HOSPITAL 830 SOUTH BUNCOMBE ROAD GREER SC 29650 GREENVILLE 8648488200 420036 SPRINGS MEMORIAL HOSPITAL 800 W MEETING ST LANCASTER SC 29720 LANCASTER 8032861481 420037 GHS‐HILLCREST MEMORIAL HOSPITAL 729 SOUTH EAST MAIN STREET SIMPSONVILLE SC 29681 GREENVILLE 8644546151 420038 GHS LAURENS COUNTY MEMORIAL HOSPITAL 22725 HIGHWAY 76 EAST CLINTON SC 29325 LAURENS 8648339100 420043 MARY BLACK HEALTH SYSTEM GAFFNEY 1530 N LIMESTONE ST GAFFNEY SC 29340 CHEROKEE 8644874271 420048 KERSHAWHEALTH 1315 ROBERTS STREET CAMDEN SC 29020 KERSHAW 8034324311 420049 CONWAY MEDICAL CENTER 300 SINGLETON RIDGE ROAD CONWAY SC 29526 HORRY 8433478037 420051 MCLEOD REGIONAL MEDICAL CENTER‐PEE DEE 555 E CHEVES ST BOX 8700 FLORENCE SC 29506 FLORENCE 8437772900 420053 NEWBERRY COUNTY MEMORIAL HOSPITAL 2669 KINARD ST PO BOX 497 NEWBERRY SC 29108 NEWBERRY 8034057145 420055 CAROLINAS HOSPITAL SYSTEM MARION 2829 E HWY 76 MULLINS SC 29574 MARION 8434312000 420057 MCLEOD MEDICAL CENTER ‐ DARLINGTON 701 CASHUA FERRY ROAD DARLINGTON SC 29540 DARLINGTON 8437771100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 184 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 420065 BON SECOURS‐ST FRANCIS XAVIER HOSPITAL 2095 HENRY TECKLENBURG DRIVE CHARLESTON SC 29414 CHARLESTON 8434021006 420066 LAKE CITY COMMUNITY HOSPITAL 258 N RON MCNAIR BLVD LAKE CITY SC 29560 FLORENCE 8433742036 420067 BEAUFORT COUNTY MEMORIAL HOSPITAL 955 RIBAUT RD BEAUFORT SC 29902 BEAUFORT 8435225200 420068 TRMC OF ORANGEBURG & CALHOUN 3000 ST MATTHEWS RD BOX 1806 ORANGEBURG SC 29115 ORANGEBURG 8035332460 420070 PALMETTO HEALTH TUOMEY HOSPITAL 129 N WASHINGTON ST SUMTER SC 29150 SUMTER 8037749000 420071 SELF REGIONAL HEALTHCARE 1325 SPRING STREET GREENWOOD SC 29646 GREENWOOD 8642274111 420072 HAMPTON REGIONAL MEDICAL CENTER 595 WEST CAROLINA AVENUE VARNVILLE SC 29944 HAMPTON 8039432771 420073 LEXINGTON MEDICAL CENTER 2720 SUNSET BLVD WEST COLUMBIA SC 29169 LEXINGTON 8037912000 420078 GHS GREENVILLE MEMORIAL HOSPITAL 701 GROVE RD GREENVILLE SC 29605 GREENVILLE 8644557000 420079 TRIDENT MEDICAL CENTER 9330 MEDICAL PLAZA DR CHARLESTON SC 29406 CHARLESTON 8438474100 420080 HILTON HEAD REGIONAL MEDICAL CENTER 25 HOSPITAL CENTER BLVD HILTON HEAD ISLAND SC 29925 BEAUFORT 8436816122 420082 AIKEN REGIONAL MEDICAL CENTER 302 UNIVERSITY PARKWAY AIKEN SC 29801 AIKEN 8036415900 420083 MARY BLACK HEALTH SYSTEM SPARTANBURG 1700 SKYLYN DR PO BOX 3217 SPARTANBURG SC 29307 SPARTANBURG 8645733000 420085 GRAND STRAND REGIONAL MEDICAL CENTER 809 82ND PARKWAY MYRTLE BEACH SC 29572 HORRY 8436921000 420086 PALMETTO HEALTH BAPTIST TAYLOR AT MARION ST COLUMBIA SC 29220 RICHLAND 8032965678 420087 ROPER HOSPITAL 316 CALHOUN ST CHARLESTON SC 29401 CHARLESTON 8437242800 420089 EAST COOPER MEDICAL CENTER 2000 HOSPITAL DR MOUNT PLEASANT SC 29464 CHARLESTON 8438810100 420091 CAROLINAS HOSPITAL SYSTEM 805 PAMPLICO HWY BOX 100550 FLORENCE SC 29505 FLORENCE 8436742500 420098 WACCAMAW COMMUNITY HOSPITAL 4070 HIGHWAY 17 BYPASS MURRELLS INLET SC 29576 GEORGETOWN 8436521000 42009F US NAVAL HOSP BEAUFORT SC 29904 BEAUFORT 420101 COASTAL CAROLINA HOSPITAL 1000 MEDICAL CENTER DRIVE HARDEEVILLE SC 29927 JASPER 8437848182 420102 GHS PATEWOOD MEMORIAL HOSPITAL 175 PATEWOOD DRIVE GREENVILLE SC 29615 GREENVILLE 8647971000 420103 PELHAM MEDICAL CENTER 250 WESTMORELAND ROAD GREER SC 29651 GREENVILLE 8645306000 420104 MOUNT PLEASANT HOSPITAL 3500 HIGHWAY 17 NORTH MOUNT PLEASANT SC 29466 CHARLESTON 8437242954 420105 MCLEOD LORIS SEACOAST HOSPITAL 3655 MITCHELL STREET LORIS SC 29569 HORRY 8437167000 420106 PALMETTO HEALTH BAPTIST PARKRIDGE 400 PALMETTO HEALTH PARKWAY COLUMBIA SC 29212 LEXINGTON 8039077011 420107 MCLEOD HEALTH CHERAW 711 CHESTERFIELD HIGHWAY CHERAW SC 29520 CHESTERFIELD 8435377881 420108 UNION MEDICAL CENTER 322 WEST SOUTH STREET UNION SC 29379 UNION 8643012000 420109 MCLEOD HEALTH CLARENDON 10 EAST HOSPITAL STREET MANNING SC 29102 CLARENDON 8034358463 42010F US NAVAL HOSP US NAVAL BASE CHARLESTON SC 29408 CHARLESTON
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 185 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 42011F JENNINGS BRYAN DORN VA MEDICAL CENTER 6439 GARNERS FERRY RD COLUMBIA SC 29202 RICHLAND 8037764000 42012F US ARMY HOSP FT JACKSON COLUMBIA SC 29207 RICHLAND 42013F US AIR FORCE HOSP MYRTLE BEACH AFB MYRTLE BEACH SC 29577 HORRY 42014F US AIR FORCE HOSP SHAW AFB SUMTER SC 29152 SUMTER 42029F RALPH H JOHNSON VA MEDICAL CENTER 109 BEE ST CHARLESTON SC 29401 CHARLESTON 8435775011 42030F US NAVAL HOSPITAL 3600 RIVERS AVE NORTH CHARLESTON SC 29405 CHARLESTON 8437435130 421300 ALLENDALE COUNTY HOSPITAL 1787 ALLENDALE FAIRFAX RD FAIRFAX SC 29827 ALLENDALE 8036323311 421301 ABBEVILLE AREA MEDICAL CENTER 420 THOMSON CIRCLE ABBEVILLE SC 29620 ABBEVILLE 8643665011 421302 FAIRFIELD MEMORIAL HOSPITAL 321 BYPASS PO BOX 620 WINNSBORO SC 29180 FAIRFIELD 8036350233 421303 WILLIAMSBURG REGIONAL HOSPITAL 500 NELSON BOULEVARD KINGSTREE SC 29556 WILLIAMSBURG 8433558888 421304 EDGEFIELD COUNTY HOSPITAL 300 RIDGE MEDICAL PLAZA EDGEFIELD SC 29824 EDGEFIELD 8036371193 422004 SPARTANBURG HOSP FOR RESTORATIVE CARE 389 SERPENTINE DR SPARTANBURG SC 29303 SPARTANBURG 8645603235 422005 VIBRA HOSPITAL OF CHARLESTON 1200 HOSPITAL DRIVE MOUNT PLEASANT SC 29464 CHARLESTON 8438814047 422006 INTERMEDICAL HOSPITAL OF SC TAYLOR AT MARION STREET COLUMBIA SC 29220 RICHLAND 8032963097 422007 REGENCY HOSPITAL OF FLORENCE 121 EAST CEDAR ST, 4TH FL FLORENCE SC 29501 FLORENCE 8436613481 422008 GHS NORTH GREENVILLE LONG TERM ACUTE CARE 807 NORTH MAIN STREET TRAVELERS REST SC 29690 GREENVILLE 8648345132 HOSPITAL 422009 REGENCY HOSPITAL OF GREENVILLE 1 ST FRANCIS DRIVE, 4TH FLOOR GREENVILLE SC 29601 GREENVILLE 8642551401 423025 HEALTHSOUTH REHABILITATION HOSPITAL OF COLUMBIA 2935 COLONIAL DRIVE COLUMBIA SC 29203 RICHLAND 8032547777
423026 HEALTHSOUTH REHABILITATION HOSPITAL OF FLORENCE 900 EAST CHEVES ST FLORENCE SC 29506 FLORENCE 8436799000
423027 HEALTHSOUTH REHABILITATION HOSP OF CHARLESTON, 9181 MEDCOM ST NORTH CHARLESTON SC 29406 CHARLESTON 8438207777 INC 423028 HEALTHSOUTH REHABILITATION HOSPITAL OF ROCK HILL 1795 FRANK GASTON BLVD ROCK HILL SC 29732 YORK 8033263500
423029 ANMED HEALTHSOUTH REHABILITATION HOSPITAL 1 SPRINGBACK WAY ANDERSON SC 29621 ANDERSON 8647162600 423030 GREENWOOD REGIONAL REHABILITATION HOSPITAL, INC 1530 PARKWAY GREENWOOD SC 29646 GREENWOOD 8643309070
423031 SPARTANBURG REHABILITATION INSTITUTE, INC 160 HAROLD FLEMING COURT SPARTANBURG SC 29303 SPARTANBURG 8646416510 423300 SHRINERS HOSPITALS FOR CHILDREN 950 WEST FARIS ROAD GREENVILLE SC 29605 GREENVILLE 8602713444 424002 LIGHTHOUSE CARE CENTER OF CONWAY 152 WACCAMAW MEDICAL PARK DRIVE CONWAY SC 29526 HORRY 8433478871 424005 G WERBER BRYAN PSYCH HOSP 220 FAISON DR COLUMBIA SC 29203 RICHLAND 8039357143
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 186 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 424006 PALMETTO LOWCOUNTRY BEHAVIORAL HEALTH 2777 SPEISSEGGER DRIVE CHARLESTON SC 29405 CHARLESTON 8437475830 424007 SPRINGBROOK BEHAVIORAL HEALTH SYSTEM ONE HAVENWOOD LANE PO BOX 1005 TRAVELERS REST SC 29690 GREENVILLE 8648348013 424008 THREE RIVERS BEHAVIORAL HEALTH 2900 SUNSET BOULEVARD WEST COLUMBIA SC 29169 LEXINGTON 8037969911 424010 CAROLINA CTR FOR BEHAVIORAL HEALTH,THE 2700 E PHILLIPS RD GREER SC 29650 GREENVILLE 8642352335 424011 PATRICK B HARRIS PSYCHIATRIC HOSPITAL 130 HIGHWAY 252 ANDERSON SC 29622 ANDERSON 8032312600 424013 THE WILLIAM J MCCORD ADOLESCENT TREATMENT 910 COOK ROAD ORANGEBURG SC 29118 ORANGEBURG 8035342328 FACILITY 424014 REBOUND BEHAVIORAL HEALTH 134 EAST REBOUND ROAD LANCASTER SC 29720 LANCASTER 8033133700 429800 MUSC MEDICAL CENTER 169 ASHLEY AVENUE CHARLESTON SC 29425 CHARLESTON 8437922300 430005 PRAIRIE LAKES HOSPITAL 401 9TH AVENUE NW POST OFFICE BOX 1210 WATERTOWN SD 57201 CODINGTON 6058827000 430008 BROOKINGS HEALTH SYSTEM 300 22ND AVE BROOKINGS SD 57006 BROOKINGS 6056969000 430012 AVERA SACRED HEART HOSPITAL 501 SUMMIT ST YANKTON SD 57078 YANKTON 6056688000 430013 AVERA QUEEN OF PEACE 525 N FOSTER MITCHELL SD 57301 DAVISON 6059952000 430014 AVERA ST LUKES 305 S STATE ST POST OFFICE BOX 4450 ABERDEEN SD 57401 BROWN 6056225000 430015 AVERA ST MARY'S HOSPITAL 801 E SIOUX PIERRE SD 57501 HUGHES 6052243100 430016 AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH 1325 S CLIFF AVE POST OFFICE BOX 5045 SIOUX FALLS SD 57117 MINNEHAHA 6053228000 CENTER 43001F U S AIR FORCE HOSP ELLSWORTH AFB ELLSWORTH AFB SD 57706 MEADE 6051234567 430027 SANFORD USD MEDICAL CENTER 1305 W 18TH ST POST OFFICE BOX 5039 SIOUX FALLS SD 57117 MINNEHAHA 6053331000 43002F V A BLACK HILLS HEALTH CARE 500 N 5TH ST FORT MEADE SD 57741 MEADE 6051234567 430048 SPEARFISH REGIONAL HOSPITAL 1440 N MAIN ST SPEARFISH SD 57783 LAWRENCE 6056444000 43005F SIOUX FALLS V A MEDICAL CENTER 2501 W 22ND ST SIOUX FALLS SD 57117 MINNEHAHA 6053363230 430077 RAPID CITY REGIONAL HOSPITAL 353 FAIRMONT BLVD POST OFFICE BOX 6000 RAPID CITY SD 57701 PENNINGTON 6057551000 430081 PHS INDIAN HOSPITAL AT PINE RIDGE HIGHWAY 18, MAIN ST., BLDG. 159 PINE RIDGE SD 57770 6058675131 430082 PHS INDIAN HOSPITAL AT RAPID CITY ‐ SIOUX SAN 3200 CANYON LAKE DR RAPID CITY SD 57702 PENNINGTON 6053552500 430083 PHS INDIAN HOSPITAL AT EAGLE BUTTE 317 MAIN STREET EAGLE BUTTE SD 57625 DEWEY 6059643005 430084 PHS INDIAN HOSPITAL AT ROSEBUD 400 SOLDIER CREEK ROAD ROSEBUD SD 57570 TODD 6057472231 430089 DUNES SURGICAL HOSPITAL 600 SIOUX POINT ROAD DAKOTA DUNES SD 57049 UNION 6052323332 430090 SIOUX FALLS SPECIALTY HOSPITAL LLP 910 EAST 20TH STREET SIOUX FALLS SD 57105 MINNEHAHA 6053346730 430091 BLACK HILLS SURGICAL HOSPITAL LLP 216 ANAMARIA DR RAPID CITY SD 57703 PENNINGTON 6057214700 430092 DAKOTA PLAINS SURGICAL CENTER LLP 701 8TH AVENUE NW SUITE C ABERDEEN SD 57401 BROWN 6052253300
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 187 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 430093 SAME DAY SURGERY CENTER LLC 651 CATHEDRAL DRIVE RAPID CITY SD 57701 PENNINGTON 6057559900 430095 AVERA HEART HOSPITAL OF SOUTH DAKOTA 4500 W 69TH ST SIOUX FALLS SD 57108 MINNEHAHA 6059777000 430096 LEWIS AND CLARK SPECIALTY HOSPITAL 2601 FOX RUN PARKWAY YANKTON SD 57078 YANKTON 6056655100 430097 SANFORD ABERDEEN MEDICAL CENTER 2905 3RD AVE SE ABERDEEN SD 57402 BROWN 6056264200 431300 MADISON REGIONAL HEALTH SYSTEM 323 SW 10TH ST MADISON SD 57042 LAKE 6052566551 431301 FAULKTON AREA MEDICAL CENTER 1300 OAK STREET POST OFFICE BOX 100 FAULKTON SD 57438 FAULK 6055986262 431302 AVERA GETTYSBURG HOSPITAL 606 EAST GARFIELD GETTYSBURG SD 57442 POTTER 6057652480 431305 DOUGLAS COUNTY MEMORIAL HOSPITAL‐CAH 708 8TH ST ARMOUR SD 57313 DOUGLAS 6057242159 431306 PLATTE HEALTH CENTER ‐ CAH 601 E 7TH ST POST OFFICE BOX 200 PLATTE SD 57369 CHARLES MIX 6053373364 431307 SANFORD CLEAR LAKE MEDICAL CENTER 701 THIRD AVENUE SOUTH CLEAR LAKE SD 57226 DEUEL 6058742141 431308 EUREKA COMMUNITY HEALTH SERVICES ‐ CAH 410 9TH ST POST OFFICE BOX 517 EUREKA SD 57437 MCPHERSON 6052842661 431309 COMMUNITY MEMORIAL HOSPITAL 809 JACKSON POST OFFICE BOX 319 BURKE SD 57523 GREGORY 6057752621 431310 AVERA FLANDREAU HOSPITAL ‐ CAH 214 NORTH PRAIRIE STREET FLANDREAU SD 57028 MOODY 6059972433 431311 SANFORD HOSPITAL WEBSTER ‐ CAH 1401 W FIRST ST POST OFFICE BOX 489 WEBSTER SD 57274 DAY 6053453336 431312 MARSHALL COUNTY HEALTHCARE CENTER ‐ CAH 413 9TH STREET BRITTON SD 57430 MARSHALL 6054482253 431313 FREEMAN MEDICAL CENTER ‐ CAH 510 E 8TH ST POST OFFICE BOX 370 FREEMAN SD 57029 HUTCHINSON 6059254000 431314 BENNETT COUNTY HOSPITAL AND NURSING HOME ‐ CAH 102 MAJOR ALLEN POST OFFICE BOX 70D MARTIN SD 57551 BENNETT 6056856622
431315 WAGNER COMMUNITY MEMORIAL HOSPITAL ‐ CAH 513 3RD ST SW POST OFFICE BOX 280 WAGNER SD 57380 CHARLES MIX 6053843611 431316 COMMUNITY MEMORIAL HOSPITAL 111 W 10TH AVE POST OFFICE BOX 420 REDFIELD SD 57469 SPINK 6054721110 431317 LANDMANN‐JUNGMAN MEMORIAL HOSPITAL ‐ CAH 600 BILLARS ST SCOTLAND SD 57059 BON HOMME 6055832226 431318 BOWDLE HOSPITAL ‐ CAH 8001 W 5TH POST OFFICE BOX 556 BOWDLE SD 57428 EDMUNDS 6052856146 431319 HANS P PETERSON MEMORIAL HOSPITAL ‐ CAH 503 W PINE POST OFFICE BOX 790 PHILIP SD 57567 HAAKON 6058592511 431320 LEAD ‐ DEADWOOD REGIONAL HOSPITAL ‐ CAH 61 CHARLES STREET DEADWOOD SD 57732 LAWRENCE 6057226101 431321 STURGIS REGIONAL HOSPITAL 949 HARMON STREET STURGIS SD 57785 MEADE 6057202400 431322 FALL RIVER HOSPITAL ‐ CAH 1201 HIGHWAY 71 SOUTH HOT SPRINGS SD 57747 FALL RIVER 6057458910 431323 CUSTER REGIONAL HOSPITAL ‐ CAH 1039 MONTGOMERY STREET CUSTER SD 57730 CUSTER 6056739400 431324 AVERA WESKOTA MEMORIAL MEDICAL CENTER ‐ CAH 604 1ST ST NE WESSINGTON SPRINGS SD 57382 JERAULD 6055391201 431325 MOBRIDGE REGIONAL HOSPITAL ‐ CAH 1401 10TH AVE WEST MOBRIDGE SD 57601 WALWORTH 6058453692 431326 MILBANK AREA HOSPITAL/AVERA HEALTH ‐ CAH 901 E VIRGIL AVE MILBANK SD 57252 GRANT 6054324538
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 188 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 431327 ST MICHAEL'S HOSPITAL ‐ CAH 410 W 16TH AVE TYNDALL SD 57066 BON HOMME 6055892100 431328 PIONEER MEMORIAL HOSPITAL ‐ CAH 315 N WASHINGTON AVE POST OFFICE BOX 368 VIBORG SD 57070 TURNER 6053265161 431329 SANFORD CHAMBERLAIN MEDICAL CENTER 300 S BYRON CHAMBERLAIN SD 57325 BRULE 6052345511 431330 AVERA ST BENEDICT HEALTH CENTER ‐ CAH 401 WEST GLYNN DRIVE PARKSTON SD 57366 HUTCHINSON 6059283311 431331 AVERA DELLS AREA HOSPITAL ‐ CAH 909 N IOWA AVE DELL RAPIDS SD 57022 MINNEHAHA 6054285431 431332 AVERA DE SMET MEMORIAL HOSPITAL ‐ CAH 306 PRAIRIE AVENUE SW POST OFFICE BOX 160 DE SMET SD 57231 KINGSBURY 6058543329 431333 SANFORD CANTON‐INWOOD MEDICAL CENTER ‐ CAH 440 NORTH HIAWATHA DRIVE CANTON SD 57013 LINCOLN 6057641400 431334 WINNER REGIONAL HEALTHCARE CENTER ‐ CAH 745 EAST 8TH STREET WINNER SD 57580 TRIPP 6058427100 431335 HURON REGIONAL MEDICAL CENTER 172 FOURTH STREET SE HURON SD 57350 BEADLE 6053536200 431336 SANFORD VERMILLION HOSPITAL 20 SOUTH PLUM STREET VERMILLION SD 57069 CLAY 6056242611 431337 AVERA HAND COUNTY MEMORIAL HOSPITAL AND CLINIC 300 W 5TH ST MILLER SD 57362 HAND 6058532421
431338 AVERA GREGORY HOSPITAL 400 PARK STREET POST OFFICE BOX 408 GREGORY SD 57533 GREGORY 6058358394 431339 COTEAU DES PRAIRIES HEALTH CARE SYSTEM 205 ORCHARD DR SISSETON SD 57262 ROBERTS 6056987647 432002 SELECT SPECIALTY HOSPITAL ‐ SIOUX FALLS 1305 WEST 18TH STREET SIOUX FALLS SD 57105 MINNEHAHA 6053129520 433300 LIFESCAPE 2501 W 26TH ST SIOUX FALLS SD 57105 MINNEHAHA 6054449500 434003 SOUTH DAKOTA HUMAN SERVICES CENTER 3515 BROADWAY AVE POST OFFICE BOX 7600 YANKTON SD 57078 YANKTON 6056683100 439801 SANFORD USD MEDICAL CENTER 1205 SOUTH GRANGE AVENUE, SUITE 201 SIOUX FALLS SD 57105 MINNEHAHA 6053289292 439802 AVERA MCKENNAN TRANSPLANT INSTITUTE 1315 S CLIFF AVE STE 1000 PO BOX 5045 SIOUX FALLS SD 57117 MINNEHAHA 6053227814 440001 UNICOI COUNTY MEMORIAL HOSPITAL GREENWAY CIRCLE ERWIN TN 37650 UNICOI 4237433141 440002 JACKSON‐MADISON COUNTY GENERAL HOSPITAL 620 SKYLINE DRIVE JACKSON TN 38301 MADISON 7315415000 440003 SUMNER REGIONAL MEDICAL CENTER 555 HARTSVILLE PIKE GALLATIN TN 37066 SUMNER 6154524210 440006 TRISTAR SKYLINE MEDICAL CENTER 3441 DICKERSON PIKE NASHVILLE TN 37207 6157692000 440007 UNITY MEDICAL CENTER 481 INTERSTATE DRIVE MANCHESTER TN 37355 COFFEE 9317283586 440008 HENDERSON COUNTY COMMUNITY HOSPITAL 200 W CHURCH ST LEXINGTON TN 38351 HENDERSON 7319681801 440009 CUMBERLAND MEDICAL CENTER 421 S MAIN ST CROSSVILLE TN 38555 CUMBERLAND 9314849511 440010 WAYNE MEDICAL CENTER 103 J V MANGUBAT DR WAYNESBORO TN 38485 WAYNE 9317225411 440011 BLOUNT MEMORIAL HOSPITAL 907 E LAMAR ALEXANDER PARKWAY MARYVILLE TN 37804 BLOUNT 8659837211 440012 WELLMONT BRISTOL REGIONAL MEDICAL CENTER ONE MEDICAL PARK BLVD BRISTOL TN 37620 SULLIVAN 4238441121 440015 THE UNIVERSITY OF TN MEDICAL CENTER 1924 ALCOA HIGHWAY KNOXVILLE TN 37920 KNOX 8655449000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 189 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 440016 BAPTIST MEMORIAL HOSPITAL HUNTINGDON 631 RB WILSON DR HUNTINGDON TN 38344 CARROLL 7319864461 440017 WELLMONT HOLSTON VALLEY MEDICAL CENTER 130 WEST RAVINE ROAD KINGSPORT TN 37662 SULLIVAN 4232244000 440018 SYCAMORE SHOALS HOSPITAL 1501 WEST ELK AVENUE ELIZABETHTON TN 37643 CARTER 4235421300 440020 SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM 1265 E COLLEGE ST PULASKI TN 38478 GILES 9313637531 PULASKI 440025 LAUGHLIN MEMORIAL HOSPITAL, INC 1420 TUSCULUM BLVD GREENEVILLE TN 37745 GREENE 4237875000 440029 WILLIAMSON MEDICAL CENTER 4321 CAROTHERS PARKWAY FRANKLIN TN 37067 WILLIAMSON 6154355000 440030 MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION 908 W 4TH NORTH ST MORRISTOWN TN 37814 HAMBLEN 4235864231 440031 ROANE MEDICAL CENTER 8045 ROANE MEDICAL CENTER DRIVE HARRIMAN TN 37748 ROANE 8653161000 440032 WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL 851 LOCUST STREET ROGERSVILLE TN 37857 HAWKINS 4239217000
440033 TENNOVA HEALTHCARE‐LAFOLLETT MEDICAL CENTER 923 EAST CENTRAL AVENUE LA FOLLETTE TN 37766 CAMPBELL 4239071440 440034 METHODIST MEDICAL CENTER OF OAK RIDGE 990 OAK RIDGE TURNPIKE BOX 529 OAK RIDGE TN 37830 ANDERSON 8658351000 440035 TENNOVA HEALTHCARE‐CLARKSVILLE 651 DUNLOP LANE CLARKSVILLE TN 37040 MONTGOMERY 9315021000 440039 VANDERBILT UNIVERSITY MEDICAL CENTER 1211 MEDICAL CENTER DRIVE NASHVILLE TN 37232 6153223454 440040 PERRY COMMUNITY HOSPITAL 2718 SQUIRREL HOLLOW DRIVE LINDEN TN 37096 PERRY 9315892121 440046 TRISTAR HORIZON MEDICAL CENTER 111 HIGHWAY 70 EAST DICKSON TN 37055 DICKSON 6154460446 440048 BAPTIST MEMORIAL HOSPITAL 6019 WALNUT GROVE ROAD MEMPHIS TN 38120 SHELBY 9012265000 440049 METHODIST HEALTHCARE MEMPHIS HOSPITALS 1265 UNION AVE SUITE 700 MEMPHIS TN 38104 SHELBY 9015168274 440050 TAKOMA REGIONAL HOSPITAL 401 TAKOMA AVE GREENEVILLE TN 37743 GREENE 4236393151 440053 SAINT THOMAS RUTHERFORD HOSPITAL 1700 MEDICAL CENTER PARKWAY MURFREESBORO TN 37129 RUTHERFORD 6153964100 440056 TENNOVA HEALTHCARE‐JEFFERSON MEMORIAL HOSPITAL 110 HOSPITAL DRIVE JEFFERSON CITY TN 37760 JEFFERSON 8654712500
440057 CLAIBORNE MEDICAL CENTER 1850 OLD KNOXVILLE HIGHWAY TAZEWELL TN 37879 CLAIBORNE 4236264211 440058 SOUTHERN TENNESSEE REGIONAL HLTH SYSTEM 185 HOSPITAL ROAD WINCHESTER TN 37398 FRANKLIN 9319678295 WINCHESTER 440059 COOKEVILLE REGIONAL MEDICAL CENTER 1 MEDICAL CENTER BOULEVARD COOKEVILLE TN 38501 PUTNAM 9316462000 440060 MILAN GENERAL HOSPITAL 4039 HIGHLAND ST MILAN TN 38358 GIBSON 7316861591 440061 TENNOVA HEALTHCARE‐VOLUNTEER MARTIN 161 MOUNT PELIA RD MARTIN TN 38237 WEAKLEY 7315874261 440063 JOHNSON CITY MEDICAL CENTER 400 N STATE OF FRANKLIN RD JOHNSON CITY TN 37604 WASHINGTON 4234316111 440064 GRANDVIEW MEDICAL CENTER 1000 HIGHWAY 28 JASPER TN 37347 MARION 4238379500 440065 NORTHCREST MEDICAL CENTER 100 NORTHCREST DRIVE SPRINGFIELD TN 37172 ROBERTSON 6153842411
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 190 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 440067 LAKEWAY REGIONAL HOSPITAL 726 MCFARLAND ST MORRISTOWN TN 37814 HAMBLEN 4235226000 440068 STARR REGIONAL MEDICAL CENTER ATHENS 1114 W MADISON AVE ATHENS TN 37371 MCMINN 4237451411 440070 DECATUR COUNTY GENERAL HOSPITAL 969 TENNESSEE AVE S PARSONS TN 38363 DECATUR 7318473031 440072 TENNOVA HEALTHCARE‐DYERSBURG REGIONAL 400 TICKLE ST DYERSBURG TN 38024 DYER 7312852410 440073 MAURY REGIONAL HOSPITAL 1224 TROTWOOD AVE COLUMBIA TN 38401 MAURY 9313811111 440081 LECONTE MEDICAL CENTER 742 MIDDLECREEK ROAD SEVIERVILLE TN 37862 CUMBERLAND 8654467500 440082 SAINT THOMAS WEST HOSPITAL 4220 HARDING RD, PO BOX 380 NASHVILLE TN 37205 6152222111 440083 TENNOVA HEALTHCARE ‐ JAMESTOWN 436 CENTRAL AVENUE WEST JAMESTOWN TN 38556 FENTRESS 9318793352 440084 SWEETWATER HOSPITAL ASSOCIATION 304 WRIGHT ST SWEETWATER TN 37874 MONROE 8652138200 440091 MEMORIAL HEALTHCARE SYSTEM, INC 2525 DESALES AVE CHATTANOOGA TN 37404 HAMILTON 4234952525 440102 LINCOLN MEDICAL CENTER 106 MEDICAL CENTER BLVD FAYETTEVILLE TN 37334 LINCOLN 9314381100 440104 ERLANGER MEDICAL CENTER 975 E 3RD ST CHATTANOOGA TN 37403 HAMILTON 4237787000 440109 HARDIN MEDICAL CENTER 935 WAYNE ROAD SAVANNAH TN 38372 HARDIN 7319268121 440110 FORT LOUDON MEDICAL CENTER 550 FORT LOUDON MEDICAL CENTER DR LENOIR CITY TN 37772 LOUDON 8652716000 440111 METRO NASHVILLE GENERAL HOSPITAL 1818 ALBION STREET NASHVILLE TN 37208 6153414490 440120 TENNOVA HEALTHCARE 900 EAST OAK HILL AVENUE KNOXVILLE TN 37917 KNOX 8655458000 440125 FORT SANDERS REGIONAL MEDICAL CENTER 1901 W CLINCH AVE KNOXVILLE TN 37916 KNOX 8655411101 440130 BAPTIST MEMORIAL HOSPITAL UNION CITY 1201 BISHOP ST, PO BOX 310 UNION CITY TN 38261 OBION 7318852410 440131 BAPTIST MEMORIAL HOSPITAL TIPTON 1995 HIGHWAY 51 S COVINGTON TN 38019 TIPTON 9014762621 440132 HENRY COUNTY MEDICAL CENTER 301 TYSON AV PARIS TN 38242 HENRY 7316421220 440133 SAINT THOMAS MIDTOWN HOSPITAL 2000 CHURCH ST NASHVILLE TN 37236 6152845555 440137 TENNOVA HEALTHCARE‐SHELBYVILLE 2835 HWY 231 N SHELBYVILLE TN 37160 BEDFORD 9316855433 44013F VETERANS AFFAIRS MEDICAL CENTER 1030 JEFFERSON AVENUE MEMPHIS TN 38104 SHELBY 9015238990 440144 TENNOVA HEALTHCARE‐HARTON 1801 N JACKSON ST BOX 460 TULLAHOMA TN 37388 COFFEE 9313933000 440148 SAINT THOMAS DEKALB HOSPITAL 520 W MAIN ST SMITHVILLE TN 37166 DEKALB 6152155000 440150 TRISTAR SUMMIT MEDICAL CENTER 5655 FRIST BLVD HERMITAGE TN 37076 6153163000 440151 SAINT THOMAS RIVER PARK HOSPITAL 1559 SPARTA STREET MC MINNVILLE TN 37110 WARREN 9318154101 440152 REGIONAL ONE HEALTH 877 JEFFERSON AVENUE MEMPHIS TN 38103 SHELBY 9015457928 440153 TENNOVA HEALTHCARE‐NEWPORT MEDICAL CENTER 435 2ND ST NEWPORT TN 37821 COCKE 4236252200 440156 PARKRIDGE MEDICAL CENTER 2333 MCCALLIE AVE CHATTANOOGA TN 37404 HAMILTON 4238944220
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 191 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 440159 DELTA MEDICAL CENTER 3000 GETWELL RD MEMPHIS TN 38118 SHELBY 9013698100 440161 TRISTAR CENTENNIAL MEDICAL CENTER 2300 PATTERSON STREET NASHVILLE TN 37203 6153421000 440162 HEALTHSOUTH CHATTANOOGA REHAB HOSPITAL 2412 MCCALLIE AVE CHATTANOOGA TN 37404 HAMILTON 4236980221 44016F JAMES H QUILLEN VA MEDICAL CENTER P O BOX 4000 MOUNTAIN HOME TN 37684 WASHINGTON 4239261171 440173 PARKWEST MEDICAL CENTER 9352 PARK WEST BLVD KNOXVILLE TN 37923 KNOX 8659709800 440175 SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM HWY 43 S BOX 847 LAWRENCEBURG TN 38464 LAWRENCE 9317626571 LAWRENCE 440176 INDIAN PATH MEDICAL CENTER 2000 BROOKSIDE DR KINGSPORT TN 37660 SULLIVAN 4234311941 44017F TN VALLEY HEALTHCARE SYSTEM ALVIN C YORK 3400 LEBANON ROAD MBORO TN 37129 RUTHERFORD 6158676000 440180 JELLICO COMMUNITY HOSPITAL 188 HOSPITAL LANE JELLICO TN 37762 CAMPBELL 4237847252 440181 BOLIVAR GENERAL HOSPITAL 650 NUCKOLLS ROAD BOLIVAR TN 38008 HARDEMAN 7316583100 440182 MCKENZIE REGIONAL HOSPITAL 161 HOSPITAL DRIVE MC KENZIE TN 38201 CARROLL 7313525344 440183 ST FRANCIS HOSPITAL 5959 PARK AVE MEMPHIS TN 38119 SHELBY 9017651000 440184 FRANKLIN WOODS COMMUNITY HOSPITAL 300 MED TECH PARKWAY JOHNSON CITY TN 37604 WASHINGTON 4233021120 440185 TENNOVA HEALTHCARE‐CLEVELAND 2305 CHAMBLISS AVE NW CLEVELAND TN 37311 BRADLEY 4233394132 440187 LIVINGSTON REGIONAL HOSPITAL 315 OAK ST BOX 550 LIVINGSTON TN 38570 OVERTON 9318235611 440189 TENNOVA HEALTHCARE‐REGIONAL JACKSON 367 HOSPITAL BLVD JACKSON TN 38305 MADISON 7316612000 44018F TN VALLEY HEALTHCARE SYSTEM NASHVILLE 1310 24TH AVENUE S NASHVILLE TN 37212 6153274751 440192 SAINT THOMAS HIGHLANDS HOSPITAL 401 SEWELL DR SPARTA TN 38583 WHITE 9317389211 440193 TENNOVA HEALTHCARE‐LEBANON 1411 BADDOUR PARKWAY LEBANON TN 37087 WILSON 6154448262 440194 TRISTAR HENDERSONVILLE MEDICAL CENTER 355 NEW SHACKLE ISLAND RD HENDERSONVILLE TN 37075 SUMNER 6153381000 440197 TRISTAR SOUTHERN HILLS MEDICAL CENTER 391 WALLACE RD NASHVILLE TN 37211 6157814000 440200 SAINT THOMAS STONES RIVER HOSPITAL 324 DOOLITTLE ROAD WOODBURY TN 37190 CANNON 6155634001 440218 SAINT THOMAS HOSPITAL FOR SPECIALTY SURGERY 2011 MURPHY AVENUE NASHVILLE TN 37203 6155158200 440227 TRISTAR STONECREST MEDICAL CENTER 200 STONECREST BOULEVARD SMYRNA TN 37167 RUTHERFORD 6157682000 440228 SAINT FRANCIS BARTLETT MEDICAL CENTER 2986 KATE BOND RD BARTLETT TN 38133 SHELBY 9018207050 440229 (CLOSED) BEHAVIORAL HEALTHCARE CENTER AT CLARK 930 PROFESSONIAL PARK DRIVE CLARKSVILLE TN 37040 MONTGOMERY 9315386420
440231 TRUSTPOINT HOSPITAL 1009 NORTH THOMPSON LANE MURFREESBORO TN 37129 RUTHERFORD 6155771111 440232 HOUSTON COUNTY COMMUNITY HOSPITAL 5001 EAST MAIN STREET ERIN TN 37061 HOUSTON 9312894211 441300 SAINT THOMAS HICKMAN HOSPITAL 135 EAST SWAN STREET CENTERVILLE TN 37033 HICKMAN 9317294271
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 192 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 441301 TROUSDALE MEDICAL CENTER 500 CHURCH STREET HARTSVILLE TN 37074 6153742221 441303 THREE RIVERS HOSPITAL 451 HIGHWAY 13 SOUTH WAVERLY TN 37185 HUMPHREYS 9312964203 441304 JOHNSON COUNTY COMMUNITY HOSPITAL 1901 S SHADY ST MOUNTAIN CITY TN 37683 JOHNSON 4237271110 441305 MACON COUNTY GENERAL HOSPITAL 204 MEDICAL DRIVE LAFAYETTE TN 37083 MACON 6156662147 441306 ERLANGER BLEDSOE HOSPITAL 71 WHEELERTOWN AVENUE PIKEVILLE TN 37367 BLEDSOE 4234472112 441307 RIVERVIEW REGIONAL MEDICAL CENTER 158 HOSPITAL DRIVE CARTHAGE TN 37030 SMITH 6157359815 441309 MARSHALL MEDICAL CENTER 1080 NORTH ELLINGTON PARKWAY LEWISBURG TN 37091 MARSHALL 9313596276 441310 RHEA MEDICAL CENTER 9400 RHEA COUNTY HIGHWAY DAYTON TN 37321 RHEA 4237751121 441311 TRISTAR ASHLAND CITY MEDICAL CENTER 313 NORTH MAIN ST ASHLAND CITY TN 37015 CHEATHAM 6157923030 441313 WELLMONT HANCOCK COUNTY HOSPITAL 1519 MAIN STREET HWY 33 SNEEDVILLE TN 37869 HANCOCK 4237335001 441314 LAUDERDALE COMMUNITY HOSPITAL 326 ASBURY AVENUE RIPLEY TN 38063 LAUDERDALE 7312212200 441315 COPPER BASIN MEDICAL CENTER HIGHWAY 68 COPPERHILL TN 37317 POLK 4234965511 441316 CAMDEN GENERAL HOSPITAL 175 HOSPITAL DRIVE CAMDEN TN 38320 BENTON 7315840109 441318 PIONEER COMMUNITY HOSPITAL OF SCOTT 18797 ALBERTA STREET ONEIDA TN 37841 SCOTT 4232865300 441319 CUMBERLAND RIVER HOSPITAL 100 OLD JEFFERSON ST CELINA TN 38551 CLAY 9312433581 442006 KINDRED HOSPITAL ‐ NASHVILLE 1412 COUNTY HOSPITAL ROAD, B‐1 NASHVILLE TN 37218 6156872600 442007 KINDRED HOSPITAL ‐ CHATTANOOGA 709 WALNUT STREET CHATTANOOGA TN 37402 HAMILTON 4232667721 442010 BAPTIST MEMORIAL RESTORATIVE CARE HOSPITAL 6019 WALNUT GROVE ROAD 1 WEST MEMPHIS TN 38120 SHELBY 9012261400 442011 SELECT SPECIALTY HOSPITAL‐NASHVILLE 2000 HAYES STREET NASHVILLE TN 37203 6152844599 442012 SELECT SPECIALTY HOSPITAL‐KNOXVILLE 1901 CLINCH AVE FORTH FLOOR N KNOXVILLE TN 37916 KNOX 8655472615 442013 METHODIST EXTENDED CARE HOSPITAL 225 SOUTH CLAYBROOK MEMPHIS TN 38104 SHELBY 9015162152 442014 SELECT SPECIALTY HOSPITAL MEMPHIS 5959 PARK AVENUE MEMPHIS TN 38119 SHELBY 9017651245 442015 SELECT SPECIALTY HOSPITAL‐NORTH KNOXVILLE 7557 B DANNAHER DRIVE SUITE 145 POWELL TN 37849 KNOX 8655457370 442016 SELECT SPECIALTY HOSPITAL‐TRICITIES ONE MEDICAL PARK BOULEVARD, 5TH FLOOR BRISTOL TN 37620 SULLIVAN 4238445900 442017 REGIONAL ONE HEALTH EXTENDED CARE HOSPITAL 890 MADISON AVENUE, 4TH FLOOR MEMPHIS TN 38103 SHELBY 9015133000 443025 SISKIN HOSPITAL FOR PHYSICAL REHABILITATION 1 SISKIN PLAZA CHATTANOOGA TN 37403 HAMILTON 4236341200 443027 HEALTHSOUTH REHABILITATION HOSPITAL 113 CASSEL DRIVE KINGSPORT TN 37660 SULLIVAN 4232467240 443028 VANDERBILT STALLWORTH REHAB HOSPITAL 2201 CHILDRENS WAY NASHVILLE TN 37212 6153207600 443029 HEALTHSOUTH REHABILITATION HOSPITAL OF MEMPHIS 1282 UNION AVENUE MEMPHIS TN 38104 SHELBY 9017222000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 193 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 443030 HEALTHSOUTH CANE CREEK REHAB HOSPITAL 180 MT PELIA ROAD MARTIN TN 38237 WEAKLEY 7315874231 443031 HEALTHSOUTH REHABILITATION HOSPITAL ‐ NORTH 4100 AUSTIN PEAY HIGHWAY MEMPHIS TN 38128 SHELBY 9012135400 443032 HEALTHSOUTH CHATTANOOGA REHAB HOSPITAL 2412 MCCALLIE AVENUE CHATTANOOGA TN 37404 HAMILTON 4236980221 443033 QUILLEN REHABILITATION HOSPITAL 2511 WESLEY STREET JOHNSON CITY TN 37601 WASHINGTON 4239521700 443034 BAPTIST MEMORIAL REHABILITATION HOSPITAL 1240 S GERMANTOWN ROAD GERMANTOWN TN 38138 SHELBY 9017571350 443035 HEALTHSOUTH REHABILITATION HOSPITAL OF FRANKLIN 1000 PHYSICIANS WAY FRANKLIN TN 37067 WILLIAMSON 2059707739
443302 ST JUDE CHILDRENS RESEARCH HOSPITAL 262 DANNY THOMAS PLACE MEMPHIS TN 38105 SHELBY 9014953300 443303 EAST TENNESSEE CHILDRENS HOSPITAL 2018 CLINCH AVE SW KNOXVILLE TN 37916 KNOX 8655418000 444001 MEMPHIS MENTAL HEALTH INSTITUTE 951 COURT AVENUE MEMPHIS TN 38103 SHELBY 9015771800 444002 MOCCASSIN BEND MENTAL HEALTH INSTITUTE 100 MOCCASIN BEND ROAD CHATTANOOGA TN 37405 HAMILTON 4237852271 444003 RIDGEVIEW PSYCHIATRIC HOSPITAL AND CENTER 240 W TYRONE RD OAK RIDGE TN 37830 ANDERSON 8654821076 444004 LAKESIDE BEHAVIORAL HEALTH SYSTEM 2911 BRUNSWICK RD MEMPHIS TN 38133 SHELBY 9013774700 444005 BEHAVIORAL HEALTHCARE CENTER AT MARTIN 458 HANNINGS LANE, P O BOX 1006 MARTIN TN 38237 WEAKLEY 7315882830 444007 ROLLING HILLS PSYCHIATRIC HOSPITAL 2014 QUAIL HOLLOW CIRCLE FRANKLIN TN 37067 WILLIAMSON 6152264930 444008 WESTERN MENTAL HEALTH INSTITUTE 11100 OLD HWY 64 WEST BOLIVAR TN 38008 HARDEMAN 7312282000 444010 PATHWAYS OF TENNESSEE, INC 238 SUMMAR DR JACKSON TN 38301 MADISON 7319358200 444014 MIDDLE TN MENTAL HEALTH INSTITUTE 221 STEWARTS FERRY PIKE NASHVILLE TN 37214 6159027565 444019 BEHAVIORAL HEALTHCARE CENTER AT CLARKSVILLE 930 PROFESSIONAL PARK DRIVE CLARKSVILLE TN 37040 MONTGOMERY 9315386420 444021 BEHAVIORAL HEALTHCARE CENTER AT COLUMBIA 1400 ROSEWOOD DRIVE COLUMBIA TN 38401 MAURY 9313886593 444022 TEN BROECK TENNESSEE 1 MEDICAL CENTER BLVD 5 WEST COOKEVILLE TN 38501 PUTNAM 9317832075 444023 OAK HILLS BEHAVIORAL CENTER 49 OLD HICKORY BLVD JACKSON TN 38305 MADISON 7316685880 444024 BEHAVIORAL HEALTHCARE CENTER AT MEMPHIS, INC 1505 N SECOND STREET MEMPHIS TN 38107 SHELBY 7318476343 444025 CRESTWYN BEHAVIORAL HEALTH 9485 CRESTWYN HILLS COVE MEMPHIS TN 38125 SHELBY 1112223456 449800 UNIVERSITY OF TN TRANSPLANT CENTER AT KNOXVILLE 1924 ALCOA HIGHWAY KNOXVILLE TN 37920 KNOX 8655449000
449802 VANDERBILT UNIVERSITY TRANSPLANT CENTER 1161 21ST AVE SOUTH NASHVILLE TN 37232 6153223454 449803 BAPTIST MEMORIAL HOSPITAL TRANSPLANT CENTER 6019 WALNUT GROVE MEMPHIS TN 38120 SHELBY 9012265000 449804 CENTENNIAL MEDICAL TRANSPLANT CENTER 2300 PATTERSON STREET NASHVILLE TN 37203 6153421000 449805 LEBONHEUR CHILDREN'S MEDICAL TRANSPLANT CENTER 50 NORTH DUNLAP MEMPHIS TN 38103 SHELBY 9015167270
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 194 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 449806 METHODIST HC TRANSPLANT 1265 UNION AVENUE MEMPHIS TN 38104 SHELBY 9015167270 449807 ERLANGER REGIONAL KIDNEY TRANSPLANT 975 EAST THIRD STREET CHATTANOOGA TN 37403 HAMILTON 4237782174 449808 ST THOMAS HOSPITAL TRANSPLANT 4220 HARDING ROAD NASHVILLE TN 37205 6152225480 450002 PROVIDENCE MEMORIAL HOSPITAL 2001 N OREGON ST EL PASO TX 79902 EL PASO 9155776011 450007 PETERSON REGIONAL MEDICAL CENTER 551 HILL COUNTRY DRIVE KERRVILLE TX 78028 KERR 8308964200 450008 CHILDREN'S HOSPITAL ‐SCOTT & WHITE HEALTHCARE 1901 SW H K DODGEN LOOP TEMPLE TX 76502 BELL 2547718600 450010 UNITED REGIONAL HEALTH CARE SYSTEM 1600 11TH STREET WICHITA FALLS TX 76301 WICHITA 9407643055 450011 ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DR BRYAN TX 77802 BRAZOS 9797763912 450015 PARKLAND HEALTH AND HOSPITAL SYSTEM 5200 HARRY HINES BLVD DALLAS TX 75235 DALLAS 2145908000 450018 UNIVERSITY OF TEXAS MEDICAL BRANCH 301 UNIVERSITY BOULEVARD GALVESTON TX 77555 GALVESTON 4097721011 450021 BAYLOR UNIVERSITY MEDICAL CENTER 3500 GASTON AVE DALLAS TX 75246 DALLAS 2148200111 450023 CITIZENS MEDICAL CENTER 2701 HOSPITAL DRIVE VICTORIA TX 77901 VICTORIA 3615725113 450024 UNIVERSITY MEDICAL CENTER OF EL PASO 4815 ALAMEDA AVE EL PASO TX 79905 EL PASO 9155217602 450028 VHS BROWNSVILLE HOSPITAL COMPANY, LLC 1040 W JEFFERSON ST BROWNSVILLE TX 78520 CAMERON 9565441400 450029 LAREDO MEDICAL CENTER 1700 EAST SAUNDERS LAREDO TX 78044 WEBB 9567965000 450032 GOOD SHEPHERD MEDICAL CENTER MARSHALL 811 S WASHINGTON MARSHALL TX 75670 HARRISON 9039276712 450033 VHS HARLINGEN HOSPITAL COMPANY LLC 2101 PEASE ST HARLINGEN TX 78550 CAMERON 9563891100 450034 CHRISTUS SOUTHEAST TEXAS‐ ST ELIZABETH 2830 CALDER AVENUE BEAUMONT TX 77702 JEFFERSON 4098927171 450035 ST JOSEPH MEDICAL CENTER 1401 ST. JOSEPH PARKWAY HOUSTON TX 77002 HARRIS 7137571000 450037 GOOD SHEPHERD MEDICAL CENTER 700 EAST MARSHALL AVENUE LONGVIEW TX 75601 GREGG 9033152000 450039 JPS HEALTH NETWORK 1500 S MAIN ST FORT WORTH TX 76104 TARRANT 8179213431 450040 COVENANT MEDICAL CENTER 3615 19TH STREET LUBBOCK TX 79410 LUBBOCK 8067256000 450042 PROVIDENCE HEALTH CENTER 6901 MEDICAL PARKWAY WACO TX 76712 MCLENNAN 2547514000 450044 UT SOUTHWESTERN UNIVERSITY HOSPITAL 6201 HARRY HINES BLVD DALLAS TX 75390 DALLAS 2146335555 450046 CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI 600 ELIZABETH STREET CORPUS CHRISTI TX 78404 NUECES 3619024103 450051 METHODIST DALLAS MEDICAL CENTER 1441 NORTH BECKLEY AVENUE DALLAS TX 75203 DALLAS 2149472879 450054 SCOTT & WHITE MEDICAL CENTER ‐ TEMPLE 2401 S 31ST ST TEMPLE TX 76508 BELL 2547242111 450055 ROLLING PLAINS MEMORIAL HOSPITAL 200 E ARIZONA SWEETWATER TX 79556 NOLAN 3252351701 450056 SETON MEDICAL CENTER AUSTIN 1201 W 38TH ST AUSTIN TX 78705 TRAVIS 5123241000 450058 BAPTIST MEDICAL CENTER 111 DALLAS STREET SAN ANTONIO TX 78205 BEXAR 2102971020
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 195 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450064 TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL 800 W RANDOL MILL RD ARLINGTON TX 76012 TARRANT 8175486100 450068 MEMORIAL HERMANN TEXAS MEDICAL CENTER 6411 FANNIN HOUSTON TX 77030 HARRIS 7137043700 450072 BRAZOSPORT REGIONAL HEALTH SYSTEM 100 MEDICAL DRIVE LAKE JACKSON TX 77566 BRAZORIA 9792974411 450076 UNIVERSITY OF TEXAS M D ANDERSON CANCER 1515 HOLCOMBE BLVD HOUSTON TX 77030 HARRIS 7137922121 CENTER,THE 450078 ANSON HOSPITAL DISTRICT 101 AVENUE J ANSON TX 79501 JONES 3258233231 450079 BAYLOR MEDICAL CENTER AT IRVING 1901 N MACARTHUR BLVD IRVING TX 75061 DALLAS 9725798100 450080 TITUS REGIONAL MEDICAL CENTER 2001 N JEFFERSON MOUNT PLEASANT TX 75455 TITUS 9035776000 450082 CHRISTUS SPOHN HOSPITAL BEEVILLE 1500 E HOUSTON HWY BEEVILLE TX 78102 BEE 3613542000 450083 EAST TEXAS MEDICAL CENTER 1000 SOUTH BECKHAM STREET TYLER TX 75701 SMITH 9035970351 450085 GRAHAM REGIONAL MEDICAL CENTER 1301 MONTGOMERY ROAD GRAHAM TX 76450 YOUNG 9405493400 450087 NORTH HILLS HOSPITAL 4401 BOOTH CALLOWAY ROAD NORTH RICHLAND HILLS TX 76180 TARRANT 8172551000 450090 NORTH TEXAS MEDICAL CENTER 1900 HOSPITAL BLVD GAINESVILLE TX 76240 COOKE 9406128600 450092 FORT DUNCAN MEDICAL CENTER 3333 N FOSTER MALDONADO BLVD EAGLE PASS TX 78852 MAVERICK 8307735321 450097 BAYSHORE MEDICAL CENTER 4000 SPENCER HWY PASADENA TX 77504 HARRIS 7133591000 450099 PAMPA REGIONAL MEDICAL CENTER 1 MEDICAL PLAZA PAMPA TX 79065 GRAY 8066653721 450101 HILLCREST BAPTIST MEDICAL CENTER 100 HILLCREST MEDICAL BLVD WACO TX 76712 MCLENNAN 2542022000 450102 MOTHER FRANCES HOSPITAL 800 EAST DAWSON TYLER TX 75701 SMITH 9035938441 450104 GUADALUPE REGIONAL MEDICAL CENTER 1215 E COURT ST SEGUIN TX 78155 GUADALUPE 8303792411 450107 LAS PALMAS MEDICAL CENTER 1801 NORTH OREGON STREET EL PASO TX 79902 EL PASO 9155211200 450108 CONNALLY MEMORIAL MEDICAL CENTER 499 10TH STREET FLORESVILLE TX 78114 WILSON 8303931300 450119 SOUTH TEXAS HEALTH SYSTEM 1102 W TRENTON ROAD EDINBURG TX 78539 HIDALGO 9566324000 450124 UNIVERSITY MEDICAL CENTER AT BRACKENRIDGE 601 E 15TH STREET AUSTIN TX 78701 TRAVIS 5123247000 450128 KNAPP MEDICAL CENTER 1401 EAST EIGHT STREET WESLACO TX 78596 HIDALGO 9569688567 450130 NIX HEALTH CARE SYSTEM 414 NAVARRO, SUITE 600 SAN ANTONIO TX 78205 BEXAR 2102712188 450132 MEDICAL CENTER HOSPITAL 500 W 4TH STREET ODESSA TX 79761 ECTOR 4326404000 450133 MIDLAND MEMORIAL HOSPITAL 400 ROSALIND REDFERN GROVER PARKWAY MIDLAND TX 79701 MIDLAND 4326851111 450135 TEXAS HEALTH HARRIS METHODIST FORT WORTH 1301 PENNSYLVANIA AVENUE FORT WORTH TX 76104 TARRANT 8172502100 450137 BAYLOR SCOTT AND WHITE ALL SAINTS MEDICAL CENTER 1400 EIGHTH AVE FORT WORTH TX 76104 TARRANT 8179262544
450143 SETON SMITHVILLE REGIONAL HOSPITAL 1201 HILL RD SMITHVILLE TX 78957 BASTROP 5122373214
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 196 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450144 PERMIAN REGIONAL MEDICAL CENTER ANDREWS COUNTY 720 HOSPITAL DRIVE ANDREWS TX 79714 ANDREWS 4325232200 HO 450147 DETAR HOSPITAL NAVARRO 506 E SAN ANTONIO ST VICTORIA TX 77902 VICTORIA 3615757441 450148 TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE 201 WALLS DRIVE CLEBURNE TX 76033 JOHNSON 8176412551
450152 METROPLEX HOSPITAL 2201 S CLEAR CREEK ROAD KILLEEN TX 76542 BELL 2545267523 450154 VAL VERDE REGIONAL MEDICAL CENTER 801 BEDELL AVE DEL RIO TX 78840 VAL VERDE 8307758566 450155 HEREFORD REGIONAL MEDICAL CENTER 801 EAST THIRD HEREFORD TX 79045 DEAF SMITH 8063642141 450162 GRACE MEDICAL CENTER 2412 50TH ST LUBBOCK TX 79412 LUBBOCK 8067884100 450163 CHRISTUS SPOHN HOSPITAL KLEBERG 1311 EAST GENERAL CAVAZOS BLVD KINGSVILLE TX 78363 KLEBERG 3615951661 450165 SOUTH TEXAS REGIONAL MEDICAL CENTER 1905 HWY 97 EAST JOURDANTON TX 78026 ATASCOSA 8307693515 450176 MISSION REGIONAL MEDICAL CENTER 900 SOUTH BRYAN ROAD MISSION TX 78572 HIDALGO 9563239000 450177 UVALDE MEMORIAL HOSPITAL 1025 GARNER FIELD ROAD UVALDE TX 78801 UVALDE 8302786251 450178 PECOS COUNTY MEMORIAL HOSPITAL 387 WEST I 10 FORT STOCKTON TX 79735 PECOS 4323364201 450184 MEMORIAL HERMANN HOSPITAL SYSTEM 1635 NORTH LOOP WEST HOUSTON TX 77008 HARRIS 7134486796 450187 SCOTT & WHITE HOSPITAL BRENHAM 700 MEDICAL PARKWAY BRENHAM TX 77833 WASHINGTON 9798366173 450192 HILL REGIONAL HOSPITAL 101 CIRCLE DRIVE HILLSBORO TX 76645 HILL 2545808500 450193 CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE ME 6720 BERTNER HOUSTON TX 77030 HARRIS 8323551000
450194 EAST TEXAS MEDICAL CENTER JACKSONVILLE 501 S RAGSDALE JACKSONVILLE TX 75766 CHEROKEE 9035415000 450196 PARIS REGIONAL MEDICAL CENTER 820 CLARKSVILLE ST PARIS TX 75460 LAMAR 9037854521 450200 WADLEY REGIONAL MEDICAL CENTER 1000 PINE STREET TEXARKANA TX 75501 BOWIE 9037988000 450203 WEATHERFORD REGIONAL MEDICAL CENTER 713 E ANDERSON ST WEATHERFORD TX 76086 PARKER 8175991190 450209 NORTHWEST TEXAS HOSPITAL 1501 COULTER ROAD AMARILLO TX 79106 POTTER 8063541110 450210 ETMC CARTHAGE 409 WEST COTTAGE CARTHAGE TX 75633 PANOLA 0936933841 450211 MEMORIAL MEDICAL CENTER OF EAST TEXAS 1201 WEST FRANK STREET LUFKIN TX 75901 ANGELINA 9366348111 450213 UNIVERSITY HEALTH SYSTEM 4502 MEDICAL DR SAN ANTONIO TX 78229 BEXAR 2103584000 450214 GULF COAST MEDICAL CENTER 10141 US 59 NORTH WHARTON TX 77488 WHARTON 9795322500 450219 BAYLOR SCOTT & WHITE MEDICAL CENTER ‐ LLANO 200 W OLLIE LLANO TX 78643 LLANO 3252475040 450222 CONROE REGIONAL MEDICAL CENTER 504 MEDICAL CENTER BLVD CONROE TX 77304 MONTGOMERY 9365391111 450229 HENDRICK MEDICAL CENTER 1900 PINE ABILENE TX 79601 TAYLOR 3256702000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 197 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450231 BAPTIST ST ANTHONY'S HOSPITAL 1600 WALLACE BLVD AMARILLO TX 79106 POTTER 8062122000 450235 MEMORIAL HOSPITAL 1110 NORTH SARAH DEWITT DRIVE GONZALES TX 78629 GONZALES 8306727581 450236 CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS 115 AIRPORT RD SULPHUR SPRINGS TX 75482 HOPKINS 9038857671
450237 CHRISTUS SANTA ROSA HOSPITAL 333 NORTH SANTA ROSA STEET SAN ANTONIO TX 78207 BEXAR 2107043342 450241 FAITH COMMUNITY HOSPITAL 215 CHISHOLM TRAIL JACKSBORO TX 76458 JACK 9405676633 450243 HAMLIN MEMORIAL HOSPITAL 632 N W SECOND STREET HAMLIN TX 79520 JONES 3255763646 450253 BELLVILLE GENERAL HOSPITAL 44 N CUMMINGS BELLVILLE TX 77418 AUSTIN 9798653141 450271 WISE REGIONAL HEALTH SYSTEM 2000 S FM 51 DECATUR TX 76234 WISE 9406275921 450272 CENTRAL TEXAS MEDICAL CENTER 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 HAYS 5127533690 450280 BAYLOR SCOTT & WHITE MEDICAL CENTER GARLAND 2300 MARIE CURIE DRIVE GARLAND TX 75042 DALLAS 9724875000 450289 HARRIS HEALTH SYSTEM 2525 HOLLY HALL HOUSTON TX 77054 HARRIS 7135666417 450292 TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN 850 ED HALL KAUFMAN TX 75142 KAUFMAN 9729327200 450293 FRIO REGIONAL HOSPITAL 200 S IH 35 PEARSALL TX 78061 FRIO 8303343617 450299 COLLEGE STATION MEDICAL CENTER 1604 ROCK PRAIRIE ROAD COLLEGE STATION TX 77842 BRAZOS 9797645151 450306 STAMFORD MEMORIAL HOSPITAL 1601 COLUMBIA STREET STAMFORD TX 79553 JONES 3257732725 450324 TEXOMA MEDICAL CENTER 5016 S US HIGHWAY 75 DENISON TX 75020 GRAYSON 9034164000 450330 OAKBEND MEDICAL CENTER 1705 JACKSON ST RICHMOND TX 77469 FORT BEND 2813413000 450340 SAN ANGELO COMMUNITY MEDICAL CENTER 3501 KNICKERBOCKER ROAD SAN ANGELO TX 76904 TOM GREEN 3259499511 450346 BAPTIST BEAUMONT HOSPITAL 3080 COLLEGE STREET BEAUMONT TX 77701 JEFFERSON 4092125012 450347 HUNTSVILLE MEMORIAL HOSPITAL 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 WALKER 9362913411 450348 FALLS COMMUNITY HOSPITAL AND CLINIC 322 COLEMAN STREET MARLIN TX 76661 FALLS 2548033561 45034E BROOKS HOSP LOUISE ST ATLANTA TX 75551 CASS 450351 TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILL 411 N BELKNAP ST STEPHENVILLE TX 76401 ERATH 2549651500
450352 HUNT REGIONAL MEDICAL CENTER 4215 JOE RAMSEY BLVD GREENVILLE TX 75401 HUNT 9034085000 450358 METHODIST HOSPITAL,THE 6565 FANNIN HOUSTON TX 77030 HARRIS 7137902221 45035E TEXAS GULF SULPHUR CO HOSP NEWGULF TX 77462 WHARTON 450369 CHILDRESS REGIONAL MEDICAL CENTER HWY 83 NORTH CHILDRESS TX 79201 CHILDRESS 9409376371 450370 COLUMBUS COMMUNITY HOSPITAL 110 SHULT DR COLUMBUS TX 78934 COLORADO 9797322371
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 198 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450372 BAYLOR SCOTT & WHITE MEDICAL CENTER‐ WAXAHACHIE 2400 N INTERSTATE HIGHWAY 35E WAXAHACHIE TX 75165 ELLIS 9729237000
450379 DALLAS MEDICAL CENTER 7 MEDICAL PARKWAY DALLAS TX 75234 DALLAS 9722471000 450388 METHODIST HOSPITAL 7700 FLOYD CURL DR SAN ANTONIO TX 78229 BEXAR 2105754000 450389 EAST TEXAS MEDICAL CENTER ATHENS 2000 SOUTH PALESTINE ATHENS TX 75751 HENDERSON 9036761000 450395 MEMORIAL MEDICAL CENTER LIVINGSTON 1717 HWY 59 BYPASS LIVINGSTON TX 77351 POLK 9363274381 450399 BROWNFIELD REGIONAL MEDICAL CENTER 705 EAST FELT STREET BROWNFIELD TX 79316 TERRY 8066373551 450400 PARKVIEW REGIONAL HOSPITAL 600 SOUTH BONHAM STREET MEXIA TX 76667 LIMESTONE 2545625332 450403 MEDICAL CENTER OF MCKINNEY 4500 MEDICAL CENTER DRIVE MCKINNEY TX 75069 COLLIN 9725478000 450411 EASTLAND MEMORIAL HOSPITAL 304 S DAUGHERTY EASTLAND TX 76448 EASTLAND 2546292601 450419 TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE 108 DENVER TRAIL AZLE TX 76020 TARRANT 8174448700 450422 BAYLOR MEDICAL CENTER AT UPTOWN 2727 EAST LEMMON AVENUE BUILDING I DALLAS TX 75204 DALLAS 2144433000 450424 HOUSTON METHODIST SAN JACINTO HOSPITAL 4401 GARTH ROAD BAYTOWN TX 77521 HARRIS 2814208600 450431 ST DAVID'S MEDICAL CENTER 919 E 32ND ST AUSTIN TX 78705 TRAVIS 5124767111 450447 NAVARRO REGIONAL HOSPITAL 3201 WEST HIGHWAY 22 CORSICANA TX 75110 NAVARRO 9036546800 450451 GLEN ROSE MEDICAL CENTER 1021 HOLDEN STREET GLEN ROSE TX 76043 SOMERVELL 2548972215 450460 TYLER COUNTY HOSPITAL 1100 WEST BLUFF WOODVILLE TX 75979 TYLER 4092838141 450462 TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS 8200 WALNUT HILL LANE DALLAS TX 75231 DALLAS 2143456789 450465 MATAGORDA REGIONAL MEDICAL CENTER 104 7TH STREET BAY CITY TX 77414 MATAGORDA 9792456383 450469 WILSON N JONES REGIONAL MEDICAL CENTER 500 N HIGHLAND AVENUE SHERMAN TX 75091 GRAYSON 9038704611 450475 ETMC HENDERSON 300 WILSON STREET HENDERSON TX 75652 RUSK 9036577541 450484 WOODLAND HEIGHTS MEDICAL CENTER 505 SOUTH JOHN REDDITT DRIVE LUFKIN TX 75904 ANGELINA 9366348311 450488 ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE 1612 SOUTH HENDERSON BLVD KILGORE TX 75662 GREGG 9039843505 450489 MEDICAL ARTS HOSPITAL 2200 N BRYAN AVE LAMESA TX 79331 DAWSON 8068722183 450497 BOWIE MEMORIAL HOSPITAL 705 EAST GREENWOOD AV BOWIE TX 76230 MONTAGUE 9408721126 450498 STEPHENS MEMORIAL HOSPITAL 200 SOUTH GENEVA STREET BRECKENRIDGE TX 76424 STEPHENS 2545592241 45049E GALVESTON CO MEM HOSP TEXAS CITY TX 77590 GALVESTON 450508 MEMORIAL HOSPITAL 1204 MOUND ST NACOGDOCHES TX 75961 NACOGDOCHES 9365644611 45050E SEYLER CLINIC & HOSP 1606 BONHAM ST COMMERCE TX 75428 HUNT 450518 THE MEDICAL CENTER OF SOUTHEAST TEXAS 2555 JIMMY JOHNSON BLVD PORT ARTHUR TX 77640 JEFFERSON 4098535900
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 199 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 45051E TIMBERLAWN SANITARIUM 4600 SAMUELL BLVD DALLAS TX 75221 DALLAS 450537 METHODIST RICHARDSON MEDICAL CENTER 2831 E PRESIDENT GEORGE BUSH HIGHWAY RICHARDSON TX 75082 DALLAS 4692041000 450539 COVENANT HOSPITAL PLAINVIEW 2601 DIMMITT RD PLAINVIEW TX 79072 HALE 8062965531 45053E UNIVERSITY OF TEXAS STUDENT HLTH CTR 105 W 26TH ST AUSTIN TX 78712 TRAVIS 45054E W I COOK CHILDRENS HOSP 1212 W LANCASTER AVE FORT WORTH TX 76102 TARRANT 450558 ABILENE REGIONAL MEDICAL CENTER 6250 HWY 83/84 ABILENE TX 79606 TAYLOR 3254281000 450563 BAYLOR SCOTT & WHITE MEDICAL CENTER GRAPEVINE 1650 W COLLEGE ST GRAPEVINE TX 76051 TARRANT 8174811588
450565 PALO PINTO GENERAL HOSPITAL 400 SOUTHWEST 25 AVE MINERAL WELLS TX 76067 PALO PINTO 9403257891 450571 SHANNON MEDICAL CENTER 120 EAST HARRIS AVENUE SAN ANGELO TX 76903 TOM GREEN 3256536741 450573 CHRISTUS JASPER MEMORIAL HOSPITAL 1275 MARVIN HANCOCK DRIVE JASPER TX 75951 JASPER 4093845461 450578 HEMPHILL COUNTY HOSPITAL 1020 S 4TH ST CANADIAN TX 79014 HEMPHILL 8063236622 450580 HOUSTON COUNTY MEDICAL CENTER 1100 LOOP 304 EAST CROCKETT TX 75835 HOUSTON 9365463890 450584 WILBARGER GENERAL HOSPITAL 920 HILLCREST DR VERNON TX 76384 WILBARGER 9405529351 450586 SEYMOUR HOSPITAL 200 STADIUM DRIVE SEYMOUR TX 76380 BAYLOR 9408895572 450587 BROWNWOOD REGIONAL MEDICAL CENTER 1501 BURNET DR BROWNWOOD TX 76801 BROWN 3256468541 45058F US AIR FORCE HOSP DYESS AFB ABILENE TX 79607 TAYLOR 450596 LAKE GRANBURY MEDICAL CENTER 1310 PALUXY RD GRANBURY TX 76048 HOOD 8175732683 450597 CUERO COMMUNITY HOSPITAL 2550 N ESPLANADE CUERO TX 77954 DEWITT 3612756191 450604 HILL COUNTRY MEMORIAL HOSPITAL INC 1020 SOUTH STATE HIGHWAY 16 FREDERICKSBURG TX 78624 GILLESPIE 8309974353 450605 CARE REGIONAL MEDICAL CENTER 1711 W WHEELER AVENUE ARANSAS PASS TX 78336 SAN PATRICIO 3617588585 45060F VA HOSP PO BOX 50600 CASHR 04A AMARILLO TX 79106 POTTER 8063559703 450610 MEMORIAL HERMANN MEMORIAL CITY MEDICAL CENTER 921 GESSNER HOUSTON TX 77024 HARRIS 7132423000
450617 CLEAR LAKE REGIONAL MEDICAL CENTER 500 MEDICAL CENTER BLVD WEBSTER TX 77598 HARRIS 2813322511 45061F US AIR FORCE HOSP BERGSTROM AFB AUSTIN TX 78743 TRAVIS 450620 DIMMIT REGIONAL HOSPITAL 704 HOSPITAL DRIVE CARRIZO SPRINGS TX 78834 DIMMIT 8308762424 45062F US AIR FORCE HOSP WEBB AIR FORCE BASE BIG SPRING TX 79720 HOWARD 450634 DENTON REGIONAL MEDICAL CENTER 3535 SOUTH I35 EAST DENTON TX 76210 DENTON 9403843535 450638 HOUSTON NORTHWEST MEDICAL CENTER 710 CYPRESS CREEK PARKWAY HOUSTON TX 77090 HARRIS 2814401000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 200 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450639 TEXAS HEALTH HARRIS METHODIST HURST‐EULESS‐ 1600 HOSPITAL PARKWAY BEDFORD TX 76022 TARRANT 8178484000 BEDFORD 45063F WEST TEXAS VA HEALTHCARE SYSTEM 300 VETERANS BLVD BIG SPRING TX 79720 HOWARD 4322637361 450641 NOCONA GENERAL HOSPITAL 100 PARK ROAD NOCONA TX 76255 MONTAGUE 9408253235 450643 DOCTORS HOSPITAL OF LAREDO 10700 MCPHERSON ROAD LAREDO TX 78041 WEBB 9565232000 450644 WEST HOUSTON MEDICAL CENTER 12141 RICHMOND AVE HOUSTON TX 77082 HARRIS 2815888080 450647 MEDICAL CITY DALLAS HOSPITAL 7777 FOREST LANE DALLAS TX 75230 DALLAS 9725666222 45064F VA HOSP EAST 9TH ST + LIPSCOMB DR BONHAM TX 75418 FANNIN 450651 MEDICAL CENTER OF PLANO 3901 W 15TH ST PLANO TX 75075 COLLIN 9725966800 450653 SCENIC MOUNTAIN MEDICAL CENTER 1601 W 11TH PLACE BIG SPRING TX 79720 HOWARD 4322631211 450654 STARR COUNTY MEMORIAL HOSPITAL 128 N FM RD 3167 RIO GRANDE CITY TX 78582 STARR 9564875561 450656 NACOGDOCHES MEDICAL CENTER 4920 NE STALLINGS DRIVE NACOGDOCHES TX 75961 NACOGDOCHES 9365699481 450658 EAST TEXAS MEDICAL CENTER ‐ FAIRFIELD 125 NEWMAN ST FAIRFIELD TX 75840 FREESTONE 9033891612 450659 PARK PLAZA HOSPITAL 1313 HERMANN DR HOUSTON TX 77004 HARRIS 7135275019 45065F US NAVAL HOSP CORPUS CHRISTI TX 78419 NUECES 450661 ODESSA REGIONAL MEDICAL CENTER 520 E 6TH STREET ODESSA TX 79761 ECTOR 4325828340 450662 VALLEY REGIONAL MEDICAL CENTER 100 A ALTON GLOOR BROWNSVILLE TX 78526 CAMERON 9563507000 450668 SIERRA MEDICAL CENTER 1625 MEDICAL CENTER DR EL PASO TX 79902 EL PASO 9157474000 450669 MEDICAL CENTER OF LEWISVILLE 500 WEST MAIN STREET LEWISVILLE TX 75057 DENTON 9724201000 45066F VA HOSP 4500 S LANCASTER RD DALLAS TX 75216 DALLAS 450670 TOMBALL REGIONAL MEDICAL CENTER 605 HOLDERRIETH TOMBALL TX 77375 HARRIS 2813511623 450672 PLAZA MEDICAL CENTER OF FORT WORTH 900 EIGHTH AVENUE FORT WORTH TX 76104 TARRANT 8173362100 450674 WOMANS HOSPITAL OF TEXAS,THE 7600 FANNIN HOUSTON TX 77054 HARRIS 7137901234 450675 MEDICAL CENTER OF ARLINGTON 3301 MATLOCK ROAD ARLINGTON TX 76015 TARRANT 8174653241 450677 TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH 11801 SOUTH FREEWAY BURLESON TX 76028 JOHNSON 8175685317
450678 BAYLOR SCOTT AND WHITE MEDICAL CENTER WHITE ROCK 9440 POPPY DR DALLAS TX 75218 DALLAS 2143246100
45067F US AIR FORCE HOSP LAUGHLIN AFB DEL RIO TX 78840 VAL VERDE 450684 MEMORIAL HERMANN NORTHEAST 18951 MEMORIAL NORTH HUMBLE TX 77338 HARRIS 2815407700 450686 UNIVERSITY MEDICAL CENTER 602 INDIANA AVENUE LUBBOCK TX 79415 LUBBOCK 8067758200
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 201 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450688 DALLAS REGIONAL MEDICAL CENTER 1011 NORTH GALLOWAY AVENUE MESQUITE TX 75149 DALLAS 2143207000 45068F WILLIAM BEAUMONT GEN HOSP DYER ST EL PASO TX 79920 EL PASO 450690 UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER 11937 US HIGHWAY 271 TYLER TX 75708 SMITH 9038777777
450694 EL CAMPO MEMORIAL HOSPITAL 303 SANDY CORNER RD EL CAMPO TX 77437 WHARTON 9795785251 450697 SOUTHWEST GENERAL HOSPITAL 7400 BARLITE BLVD SAN ANTONIO TX 78224 BEXAR 2109212000 450698 LAMB HEALTHCARE CENTER 1500 S SUNSET LITTLEFIELD TX 79339 LAMB 8063856411 45069F US ARMY HOSP BROOKE ARMY MEDICAL CENTER FORT SAM HOUSTON TX 78234 BEXAR 450702 LONGVIEW REGIONAL MEDICAL CENTER 2901 N FOURTH ST LONGVIEW TX 75605 GREGG 9037581818 450709 HOUSTON METHODIST ST JOHN HOSPITAL 18300 ST JOHN DRIVE NASSAU BAY TX 77058 HARRIS 2813335503 45070F US ARMY HOSP FORT HOOD TX 76544 BELL 450711 RIO GRANDE REGIONAL HOSPITAL 101 E RIDGE RD MCALLEN TX 78503 HIDALGO 9566326000 450713 ST DAVID'S SOUTH AUSTIN MEDICAL CENTER 901 WEST BEN WHITE BLVD AUSTIN TX 78704 TRAVIS 5124487107 450716 CYPRESS FAIRBANKS MEDICAL CENTER 10655 STEEPLETOP DRIVE HOUSTON TX 77065 HARRIS 2818973100 450718 ROUND ROCK MEDICAL CENTER 2400 ROUND ROCK AVE ROUND ROCK TX 78681 WILLIAMSON 5123411000 45071F US AIR FORCE HOSP CARSWELL AFB FORT WORTH TX 76127 TARRANT 450723 METHODIST CHARLTON MEDICAL CENTER 3500 W WHEATLAND ROAD DALLAS TX 75237 DALLAS 2149477777 45072F US PUBLIC HEALTH SERVICE HOSP P O BOX 100 FORT WORTH TX 76119 TARRANT 450730 BAYLOR SCOTT AND WHITE MEDICAL CENTER CARROLLTON 4343 NORTH JOSEY LANE CARROLLTON TX 75010 DENTON 9723942255
45073F US PUBLIC HEALTH SERVICE HOSP 45TH ST + AVE N GALVESTON TX 77550 GALVESTON 450742 BAYLOR SCOTT AND WHITE MEDICAL CENTER LAKE POINTE 6800 SCENIC DR ROWLETT TX 75088 DALLAS 9724122273
450743 TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON 3000 N I‐35 DENTON TX 76201 DENTON 9408987000 450746 KNOX COUNTY HOSPITAL 701 SE 5TH STREET KNOX CITY TX 79529 KNOX 9406573535 450747 PALESTINE REGIONAL MEDICAL CENTER 2900 S LOOP 256 PALESTINE TX 75801 ANDERSON 9037311000 450749 EAST TEXAS MEDICAL CENTER TRINITY 317 PROSPECT DR/PO BOX 3169 TRINITY TX 75862 TRINITY 9365943541 45074F VA HOSP 2002 HOLCOMBE BLVD HOUSTON TX 77031 HARRIS 450754 HAMILTON GENERAL HOSPITAL 400 N BROWN, BUILDING 1 HAMILTON TX 76531 HAMILTON 2543863151 450755 COVENANT HOSPITAL LEVELLAND 1900 COLLEGE AVE LEVELLAND TX 79336 HOCKLEY 8068944963 45075F VA HOSP KERRVILLE TX 78028 KERR
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 202 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450766 UT SOUTHWESTERN UNIVERSITY HOSPITAL‐ZALE LIPSHY 5151 HARRY HINES BLVD DALLAS TX 75390 DALLAS 2148793758
45076F FEDERAL CORRECTIONAL INSTITUTE HOSP LA TUNA TX 79840 450771 TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO 6200 W PARKER RD PLANO TX 75093 COLLIN 9729818000 450774 TOPS SURGICAL SPECIALTY HOSPITAL 17080 RED OAK DRIVE HOUSTON TX 77090 HARRIS 2815392900 450775 KINGWOOD MEDICAL CENTER 22999 US HWY 59 KINGWOOD TX 77325 HARRIS 2813597500 450779 TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST 6100 HARRIS PKWY FORT WORTH TX 76132 TARRANT 8174335000 F 45077F US AIR FORCE HOSP LAREDO AFB LAREDO TX 78040 WEBB 450780 METHODIST AMBULATORY SURGERY HOSPITAL NW 9150 HUEBNER RD SUITE 100 SAN ANTONIO TX 78240 BEXAR 2105755000 450788 CORPUS CHRISTI MEDICAL CENTER,THE 7101 S PADRE ISLAND DR CORPUS CHRISTI TX 78412 NUECES 3617611501 45078F US AIR FORCE HOSP REESE AFB LUBBOCK TX 79401 LUBBOCK 450797 HOUSTON HOSPITAL FOR SPECIALIZED SURGERY 5445 LABRANCH STREET HOUSTON TX 77004 HARRIS 7135286800 45079F VA HOSP 1016 WARD ST MARLIN TX 76661 FALLS 450801 CHRISTUS ST MICHAEL HEALTH SYSTEM 2600 ST MICHAEL DR TEXARKANA TX 75504 BOWIE 9036141000 450803 DOCTORS HOSPITAL TIDWELL 510 W TIDWELL HOUSTON TX 77091 HARRIS 7136911111 450804 TEXAS ORTHOPEDIC HOSPITAL 7401 SOUTH MAIN STREET HOUSTON TX 77030 HARRIS 7137998600 450808 NORTHWEST HILLS SURGICAL HOSPITAL 6818 AUSTIN CTR BLVD SUITE 100 AUSTIN TX 78731 TRAVIS 5123461994 450809 NORTH AUSTIN MEDICAL CENTER 12221 MOPAC EXPRESSWAY NORTH AUSTIN TX 78758 TRAVIS 5129011000 45080F US ARMY HOSP FT WOLTERS MINERAL WELLS TX 76067 PALO PINTO 45081F WILFORD HALL MEDICAL CENTER 2200 BERGUISTE DR SUITE 1 LACKLAND A F B TX 78236 BEXAR 2106712907 450820 METHODIST SUGAR LAND HOSPITAL 16655 SOUTHWEST FREEWAY SUGAR LAND TX 77479 FORT BEND 2812748000 450822 LAS COLINAS MEDICAL CENTER 6800 N MACARTHUR BLVD IRVING TX 75039 DALLAS 9729692000 450825 CORNERSTONE REGIONAL HOSPITAL 2302 CORNERSTONE BOULEVARD EDINBURG TX 78539 HIDALGO 9566184444 450827 KELL WEST REGIONAL HOSPITAL 5402 KELL WEST BOULEVARD WICHITA FALLS TX 76310 WICHITA 9406925888 450828 CHRISTUS SPOHN HOSPITAL ALICE 2500 E MAIN STREET ALICE TX 78332 JIM WELLS 3616618016 45082F US AIR FORCE HOSP GOODFELLOW AFB SAN ANGELO TX 76901 TOM GREEN 450831 SURGERY SPECIALTY HOSPITALS OF AMERICA SE HOUSTON 4301 B VISTA PASADENA TX 77504 HARRIS 7133783000
450833 ENNIS REGIONAL MEDICAL CENTER 2201 WEST LAMPASAS STREET ENNIS TX 75119 ELLIS 9728750900 450834 PHYSICIANS CENTRE,THE 3131 UNIVERSITY DRIVE EAST BRYAN TX 77802 BRAZOS 9797313100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 203 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 45083F US AIR FORCE HOSP RANDOLPH AFB SAN ANTONIO TX 78148 BEXAR 450840 TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN 1105 CENTRAL EXPRESSWAY NORTH ALLEN TX 75013 COLLIN 9727476197 450844 METHODIST WILLOWBROOK HOSPITAL 18220 TOMBALL PARKWAY HOUSTON TX 77070 HARRIS 2814771000 450845 EL PASO SPECIALTY HOSPITAL 1755 CURIE SUITE AEL PASO TX 79902 EL PASO 9155443636 450847 MEMORIAL HERMANN KATY HOSPITAL 23900 KATY FREEWAY KATY TX 77494 HARRIS 2813921111 450848 MEMORIAL HERMANN SUGAR LAND HOSPITAL 17500 W GRAND PARKWAY SOUTH SUGAR LAND TX 77479 FORT BEND 2814994800 45084F FEDERAL CORRECTIONAL INSTITUTE HOSP SEAGOVILLE TX 75159 DALLAS 450851 BAYLOR HEART AND VASCULAR HOSPITAL 621 NORTH HALL STREET DALLAS TX 75226 DALLAS 2148200670 450853 BAYLOR MEDICAL CENTER AT FRISCO 5601 WARREN PARKWAY FRISCO TX 75034 COLLIN 2146182000 450855 HARLINGEN MEDICAL CENTER 5501 SOUTH EXPRESSWAY 77 HARLINGEN TX 78550 CAMERON 9563651000 450856 SOUTH TEXAS SPINE AND SURGICAL HOSPITAL 18600 NORTH HARDY OAK BLVD SAN ANTONIO TX 78258 BEXAR 2104040800 45085F US AIR FORCE HOSP PERRIN AFB SHERMAN TX 75090 GRAYSON 450860 SUGAR LAND SURGICAL HOSPITAL LLP 16906 SOUTHWEST FREEWAY SUGAR LAND TX 77479 FORT BEND 2812431000 450862 ST LUKE'S THE WOODLANDS HOSPITAL 17200 ST LUKE'S WAY THE WOODLANDS TX 77384 MONTGOMERY 9362664050 450864 TEXAS SPINE AND JOINT HOSPITAL 1814 ROSELAND BOULEVARD TYLER TX 75701 SMITH 9035253300 450865 SETON SOUTHWEST HOSPITAL 7900 FM 1826 AUSTIN TX 78737 TRAVIS 5123249000 450867 SETON NORTHWEST HOSPITAL 11113 RESEARCH BOULEVARD AUSTIN TX 78759 TRAVIS 5123246000 450869 DOCTORS HOSPITAL AT RENAISSANCE 5501 SOUTH MCCOLL EDINBURG TX 78539 HIDALGO 9563628677 45086F VA CENTER TEMPLE TX 76501 BELL 450871 ARISE AUSTIN MEDICAL CENTER 3003 BEE CAVES ROAD AUSTIN TX 78746 TRAVIS 5123479888 450872 USMD HOSPITAL AT ARLINGTON L P 801 W INTERSTATE 20 ARLINGTON TX 76017 TARRANT 8174723400 450873 PROMISE SPECIALTY HOSPITAL OF SAN ANTONIO (452090) 7400 BARLITE BOULEVARD 2ND FLOOR SAN ANTONIO TX 78224 BEXAR 2109254165
450874 BAYLOR SURGICAL HOSPITAL AT LAS COLINAS 400 WEST INTERSTATE 635 SUITE 101 IRVING TX 75063 DALLAS 9728684000 450875 QUAIL CREEK SURGICAL HOSPITAL 6819 PLUM CREEK AMARILLO TX 79124 POTTER 8063546100 450876 LUBBOCK HEART HOSPITAL LP 4810 NORTH LOOP 289 LUBBOCK TX 79416 LUBBOCK 8066877777 450877 FOUNDATION SURGICAL HOSPITAL OF EL PASO 1416 GEORGE DIETER EL PASO TX 79936 EL PASO 9155984240 45087F US AIR FORCE HOSP JAMES CONNALLY AFB WACO TX 76703 MCLENNAN 450880 BAYLOR SURGICAL HOSPITAL AT FORT WORTH 1800 PARK PLACE AVENUE FORT WORTH TX 76110 TARRANT 6827035600 450883 BAYLOR MEDICAL CENTER AT TROPHY CLUB 2850 E STATE HIGHWAY 114 TROPHY CLUB TX 76262 DENTON 8178374600
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 204 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 450885 BAYLOR SCOTT AND WHITE MEDICAL CENTER CENTENNIAL 12505 LEBANON ROAD FRISCO TX 75035 COLLIN 9729633333
450886 SOUTHWEST SURGICAL HOSPITAL 1612 HURST TOWN CENTER DRIVE HURST TX 76054 TARRANT 8173454100 450888 TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHLAKE 1545 E SOUTHLAKE BLVD SOUTHLAKE TX 76092 TARRANT 8177488700
450889 TEXAS INSTITUTE FOR SURGERY AT PRESBYTERIAN HOSPIT 7115 GREENVILLE AVENUE SUITE 100 DALLAS TX 75231 DALLAS 2146475300
45088F VA HOSP WACO TX 76703 MCLENNAN 450890 BAYLOR REGIONAL MEDICAL CENTER AT PLANO 4700 ALLIANCE BOULEVARD PLANO TX 75093 COLLIN 4698142000 450891 TEXAS HEALTH CENTER FOR DIAGNOSTICS & SURGERY 6020 W PARKER ROAD PLANO TX 75093 COLLIN 9724032700 PLAN 450893 THE HEART HOSPITAL BAYLOR DENTON 2801 SOUTH MAYHILL ROAD DENTON TX 76208 DENTON 9402200600 450894 PINE CREEK MEDICAL CENTER LLP 9032 HARRY HINES BLVD DALLAS TX 75235 DALLAS 2142312273 45089F US AIR FORCE HOSP SHEPPARD AFB WICHITA FALLS TX 76311 WICHITA 45090F SOUTH TEXAS VETERANS HEALTH CARE SYS 7400 MERTON MINTER BOULEVARD SAN ANTONIO TX 78284 BEXAR 2106175300 45095E COWPER CLINIC 1500 GREGG ST BIG SPRING TX 79720 HOWARD 45107E BEAUMONT REMEDIAL CLINIC 1105 BROADWAY BEAUMONT TX 77703 JEFFERSON 45108E CASA BLANCA HOSP 2345 REAGON ST DALLAS TX 75219 DALLAS 45112E CITY HOSP P O BOX 298 HEMPHILL TX 75948 SABINE 45116E JONES CHILDRENS HAVEN HOSP 3611 FAIRMOUNT ST DALLAS TX 75219 DALLAS 45117E TEXAS CLINIC HOSP 3017 FAIRMOUNT DALLAS TX 75201 DALLAS 45118E SHRINERS HOSP FOR CRIPPLED CHILDREN 610 TEXAS AVE GALVESTON TX 77550 GALVESTON 45121E SAINTS HOSP 501 S HACKENBERRY ST SAN ANTONIO TX 78219 BEXAR 45122E MEDICAL & SURGICAL CLINIC HOSP 1100 S BECKHAM ST TYLER TX 75701 SMITH 451300 PARMER COUNTY COMMUNITY HOSPITAL 1307 CLEVELAND STREET FRIONA TX 79035 PARMER 8062502754 451301 REAGAN MEMORIAL HOSPITAL 805 NORTH MAIN BIG LAKE TX 76932 REAGAN 3258442561 451303 LIMESTONE MEDICAL CENTER 701 MCCLINTIC DRIVE GROESBECK TX 76642 LIMESTONE 2547293281 451304 SCHLEICHER COUNTY MEDICAL CENTER 102 NORTH US HIGHWAY 277 ELDORADO TX 76936 SCHLEICHER 3258532507 451305 BURLESON ST JOSEPH HEALTH CENTER 1101 WOODSON DRIVE CALDWELL TX 77836 BURLESON 9795673245 451306 KIMBLE HOSPITAL 349 REID ROAD JUNCTION TX 76849 KIMBLE 3254463321 451307 IRAAN GENERAL HOSPITAL 600 HIGHWAY 349 NORTH IRAAN TX 79744 PECOS 4326392575 451308 YOAKUM COUNTY HOSPITAL 412 MUSTANG AVENUE DENVER CITY TX 79323 YOAKUM 8065922121
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 205 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 451309 MCCAMEY HOSPITAL 2500 HWY 305 SOUTH MCCAMEY TX 79752 UPTON 4326528626 451310 BALLINGER MEMORIAL HOSPITAL 608 AVENUE B BALLINGER TX 76821 RUNNELS 3253652531 451311 SWEENY COMMUNITY HOSPITAL 305 NORTH MCKINNEY SWEENY TX 77480 BRAZORIA 9795483311 451312 RICE MEDICAL CENTER 600 SOUTH AUSTIN ROAD EAGLE LAKE TX 77434 COLORADO 9792345571 451313 FISHER COUNTY HOSPITAL DISTRICT 774 STATE HIGHWAY 70 N ROTAN TX 79546 FISHER 3257352256 451314 WINKLER COUNTY MEMORIAL HOSPITAL 821 JEFFEE DRIVE KERMIT TX 79745 WINKLER 4325865865 451315 NORTH RUNNELS HOSPITAL 7821 EAST HIGHWAY 153 WINTERS TX 79567 RUNNELS 3257544553 451316 MADISON ST JOSEPH HEALTH CENTER 100 WEST CROSS STREET MADISONVILLE TX 77864 MADISON 9363482631 451317 REFUGIO COUNTY MEMORIAL HOSPITAL 107 SWIFT STREET REFUGIO TX 78377 REFUGIO 3615262321 451318 STONEWALL MEMORIAL HOSPITAL 821 NORTH BROADWAY ASPERMONT TX 79502 STONEWALL 9409893551 451319 MOTHER FRANCES HOSPITAL JACKSONVILLE 2026 S JACKSON STREET JACKSONVILLE TX 75766 CHEROKEE 9035414500 451320 BAYSIDE COMMUNITY HOSPITAL 200 HOSPITAL DRIVE ANAHUAC TX 77514 CHAMBERS 4092673143 451322 GRIMES ST JOSEPH HEALTH CENTER 210 JUDSON ST NAVASOTA TX 77868 GRIMES 9368256585 451323 ROLLINS BROOK COMMUNITY HOSPITAL 608 NORTH KEY AVENUE LAMPASAS TX 76550 LAMPASAS 5125563682 451324 LILLIAN M HUDSPETH MEMORIAL HOSPITAL 308 HUDSPETH SONORA TX 76950 SUTTON 3253872521 451325 CONCHO COUNTY HOSPITAL 614 EAKER STREET EDEN TX 76837 CONCHO 9158695911 451326 CHILLICOTHE HOSPITAL DISTRICT 303 AVENUE I CHILLICOTHE TX 79225 HARDEMAN 9408525131 451328 RICELAND MEDICAL CENTER 538 BROADWAY WINNIE TX 77665 CHAMBERS 4092966000 451329 RANKIN HOSPITAL MEDICAL CLINIC 1611 SPUR 576 RANKIN TX 79778 UPTON 4326932443 45132E ELMWOOD SANATORIUM 2805 KIMBRO RD FORT WORTH TX 76111 TARRANT 451330 MEDINA REGIONAL HOSPITAL 3100 AVENUE E HONDO TX 78861 MEDINA 8304267700 451331 COON MEMORIAL HOSPITAL 1411 DENVER AVENUE DALHART TX 79022 DALLAM 8062444571 451332 PALACIOS COMMUNITY MEDICAL CENTER 311 GREEN AVENUE PALACIOS TX 77465 MATAGORDA 3619722511 451333 MARTIN COUNTY HOSPITAL DISTRICT 600 E INTERSTATE 20 PO BOX 640 STANTON TX 79782 MARTIN 4327563345 451334 PARKVIEW HOSPITAL 901 S. SWEETWATER WHEELER TX 79096 WHEELER 8068265581 451335 MUENSTER MEMORIAL HOSPITAL 605 N MAPLE STREET MUENSTER TX 76252 COOKE 9407592271 451337 W J MANGOLD MEMORIAL HOSPITAL 320 NORTH MAIN LOCKNEY TX 79241 FLOYD 8066523373 451338 CULBERSON HOSPITAL EISENHOWER ROAD AND FM 2185 VAN HORN TX 79855 CULBERSON 4322832760 451339 THROCKMORTON COUNTY MEMORIAL HOSPITAL 802 N MINTER AVENUE THROCKMORTON TX 76483 THROCKMORTON 9408492151 451340 SHAMROCK GENERAL HOSPITAL 1000 SOUTH MAIN STREET SHAMROCK TX 79079 WHEELER 8062562114
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 206 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 451341 HASKELL MEMORIAL HOSPITAL 1 NORTH AVENUE N PO BOX 1117 HASKELL TX 79521 HASKELL 9408642621 451342 MITCHELL COUNTY HOSPITAL DISTRICT 997 WEST I‐20 COLORADO CITY TX 79512 MITCHELL 3257283431 451343 ELECTRA MEMORIAL HOSPITAL 1207 S BAILEY STREET ELECTRA TX 76360 WICHITA 9404953981 451344 HANSFORD COUNTY HOSPITAL 707 ROLAND ST SPEARMAN TX 79081 HANSFORD 8066592535 451345 CROSBYTON CLINIC HOSPITAL 710 WEST MAIN STREET CROSBYTON TX 79322 CROSBY 8066752382 451346 YOAKUM COMMUNITY HOSPITAL 1200 CARL RAMERT DRIVE YOAKUM TX 77995 DEWITT 3612932321 451347 COLEMAN COUNTY MEDICAL CENTER COMPANY 310 SOUTH PECOS STREET COLEMAN TX 76834 COLEMAN 3256252135 451348 HEART OF TEXAS MEMORIAL HOSPITAL 2008 NINE ROAD BRADY TX 76825 MCCULLOCH 3255972901 451349 SWISHER MEMORIAL HOSPITAL 539 SOUTHEAST 2ND TULIA TX 79088 SWISHER 8069953581 451350 PLAINS MEMORIAL HOSPITAL 310 WEST HALSELL STREET DIMMITT TX 79027 CASTRO 8066472191 451351 LYNN COUNTY HOSPITAL DISTRICT 2600 LOCKWOOD STREET TAHOKA TX 79373 LYNN 8069984533 451352 HARDEMAN COUNTY MEMORIAL HOSPITAL 402 MERCER ST QUANAH TX 79252 HARDEMAN 9406632795 451353 CRANE COUNTY HOSPITAL DISTRICT 1310 S ALFORD ST CRANE TX 79731 CRANE 4325583555 451354 HAMILTON HOSPITAL 901 WEST HAMILTON OLNEY TX 76374 YOUNG 9405645521 451355 COLLINGSWORTH GENERAL HOSPITAL 1013 15TH ST WELLINGTON TX 79095 COLLINGSWORTH 8064472521 451356 MEMORIAL MEDICAL CENTER 815 N VIRGINIA STREET PORT LAVACA TX 77979 CALHOUN 3615526713 451357 LITTLE RIVER HEALTHCARE 1700 BRAZOS ROCKDALE TX 76567 MILAM 5124464500 451358 MEMORIAL HOSPITAL 209 NORTHWEST 8TH STREET SEMINOLE TX 79360 GAINES 4327584854 451359 OCHILTREE GENERAL HOSPITAL 3101 GARRETT DRIVE PERRYTON TX 79070 OCHILTREE 8064353606 451360 CHI ST LUKES HEALTH MEMORIAL SAN AUGUSTINE 511 HOSPITAL ST SAN AUGUSTINE TX 75972 SAN AUGUSTINE 9362753446 451361 SABINE COUNTY HOSPITAL PO BOX 750, 2301 HWY 83 W HEMPHILL TX 75948 SABINE 4097873300 451362 CLAY COUNTY MEMORIAL HOSPITAL 310 W SOUTH STREET HENRIETTA TX 76365 CLAY 9405385621 451363 JACKSON HEALTHCARE CENTER 1013 S WELLS EDNA TX 77957 JACKSON 3617827800 451364 OTTO KAISER MEMORIAL HOSPITAL 3349 S HIGHWAY 181 KENEDY TX 78119 KARNES 8305833401 451365 SETON HIGHLAND LAKES HIGHWAY 281 SOUTH BURNET TX 78611 BURNET 5127153000 451366 COCHRAN MEMORIAL HOSPITAL 205 E GRANT STREET MORTON TX 79346 COCHRAN 8062665565 451367 EAST TEXAS MEDICAL CENTER PITTSBURG 2701 US HWY 271 N PITTSBURG TX 75686 CAMP 9038564520 451369 GOLDEN PLAINS COMMUNITY HOSPITAL 100 MEDICAL DRIVE BORGER TX 79007 HUTCHINSON 8062731100 451370 TMC‐ BONHAM HOSPITAL 504 LIPSCOMB STREET BONHAM TX 75418 FANNIN 9036407311 451371 SETON EDGAR B DAVIS HOSPITAL 130 HAYS STREET LULING TX 78648 CALDWELL 8308757000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 207 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 451372 MULESHOE AREA MEDICAL CENTER 708 S 1ST ST MULESHOE TX 79347 BAILEY 8062724524 451373 WARD MEMORIAL HOSPITAL 406 SOUTH GARY ST MONAHANS TX 79756 WARD 4329432511 451374 BAYLOR SCOTT & WHITE MEDICAL CENTER ‐TAYLOR 305 MALLARD TAYLOR TX 76574 WILLIAMSON 5123527611 451375 LIBERTY DAYTON REGIONAL MEDICAL CENTER 1353 N TRAVIS ST LIBERTY TX 77575 LIBERTY 9363367316 451376 LAVACA MEDICAL CENTER 1400 NORTH TEXANA STREET HALLETTSVILLE TX 77964 LAVACA 3617983671 451377 REEVES COUNTY HOSPITAL DISTRICT 2323 TEXAS STREET PECOS TX 79772 REEVES 4324473551 451378 BIG BEND REGIONAL MEDICAL CENTER 2600 HIGHWAY 118 NORTH ALPINE TX 79830 BREWSTER 4328373447 451379 CORYELL MEMORIAL HEALTHCARE SYSTEM 1507 W MAIN STREET GATESVILLE TX 76528 CORYELL 2548658251 451380 EAST TEXAS MEDICAL CENTER QUITMAN 117 WINNSBORO STREET QUITMAN TX 75783 WOOD 9037634500 451381 MOTHER FRANCES HOSPITAL‐ WINNSBORO 719 WEST COKE ROAD WINNSBORO TX 75494 WOOD 9033425227 451382 COMANCHE COUNTY MEDICAL CENTER 10201 HWY 16 COMANCHE TX 76442 COMANCHE 2548794900 451384 COGDELL MEMORIAL HOSPITAL 1700 COGDELL BLVD SNYDER TX 79549 SCURRY 3255747437 451385 GOODALL WITCHER HOSPITAL 101 POSEY AVENUE CLIFTON TX 76634 BOSQUE 2546758322 451386 MEMORIAL HOSPITAL 224 E SECOND STREET DUMAS TX 79029 MOORE 8069357171 45145E MEDICAL ARTS CLINIC HOSP 710 GREGG ST BIG SPRING TX 79720 HOWARD 45146E SINTON HOSP 509 W MARKET ST SINTON TX 78387 SAN PATRICIO 45148E ST JUDES OAK RIDGE HOSP 3200 S 1ST ST AUSTIN TX 78704 TRAVIS 45154E DAYTON MEM HOSP 702 N WINFREE DAYTON TX 77535 LIBERTY 45157E MAX MIXSON MEM CLINIC HOSP 200 E LEVIELLE KIRBYVILLE TX 75956 JASPER 45159E DEVEREUX FOUNDATION,THE FOUTS FIELD VICTORIA TX 77901 VICTORIA 45160E FT WORTH NEUROPSYCHIATRIC HOSP 1066 W MAGNOLIA FORT WORTH TX 76104 TARRANT 45161E JACKSON CLINIC HOSP 612 S ROCKWALL TERRELL TX 75160 KAUFMAN 45164E BUROW CLINIC HOSP 415 COLLEGE ST KILLEEN TX 76541 BELL 45165E PARK NORTH GENERAL HOSP 4330 VANCE JACKSON SAN ANTONIO TX 78230 BEXAR 45167E HURST‐EULESS‐BEDFORD HOSP 1600 HOSPITAL PARKWAY BEDFORD TX 76021 TARRANT 45168E WYLIE HOSP 103 N 1ST ST WYLIE TX 75098 DALLAS 45170E SCHICK HOSP 4101 FRAWLEY FORT WORTH TX 76118 TARRANT 45185E REAGAN MEMORIAL HOSPITAL 805 N MAIN AVE BIG LAKE TX 76932 REAGAN 9158842561 45186E VETERANS ADMINISTRATION HOSPITAL 4500 S LANCASTER RD DALLAS TX 75216 DALLAS 2143765451 45187E CROCKETT COUNTY HOSP 103 AVE H OZONA TX 76943 CROCKETT 9153922671
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 208 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 45188E ENNIS REGIONAL MEDICAL CENTER 803 WEST LAMPASAS ENNIS TX 75119 ELLIS 9728750900 45189E DICKERSON MEMORIAL HOSPITAL 1001 DICKERSON DRIVE JASPER TX 75951 JASPER 4093842203 45190E ST LUKE'S COMMUNITY MEDICAL CENTER 17200 ST LUKE'S WAY THE WOODLANDS TX 77384 MONTGOMERY 9362664050 451990 LEAVES,THE 1230 WEST SPRING VALLEY ROAD RICHARDSON TX 75080 DALLAS 9722314864 452015 KINDRED HOSPITAL DALLAS 9525 GREENVILLE AVENUE DALLAS TX 75218 DALLAS 2143552600 452016 KINDRED HOSPITAL SAN ANTONIO 3636 MEDICAL DRIVE SAN ANTONIO TX 78229 BEXAR 2106160616 452018 TEXAS HEALTH SPECIALTY HOSPITAL FORT WORTH 1300 PENNSYLVANIA 4TH FLOOR MAIN BLDG FORT WORTH TX 76104 TARRANT 8178785500 452019 KINDRED HOSPITAL FORT WORTH‐ MANSFIELD 1802 HIGHWAY 157 NORTH MANSFIELD TX 76063 TARRANT 8173324812 452022 SELECT SPECIALTY HOSPITAL‐DALLAS 2329 PARKER ROAD CARROLLTON TX 75010 DENTON 9728842407 452023 KINDRED HOSPITAL HOUSTON MEDICAL CENTER 6441 MAIN ST HOUSTON TX 77030 HARRIS 7137900500 452028 KINDRED HOSPITAL‐TARRANT COUNTY 1000 N COOPER ST ARLINGTON TX 76011 TARRANT 8175430200 452029 CONTINUE CARE HOSPITAL AT HENDRICK MEDICAL CENTER 1900 PINE ST 5TH FLOOR ABILENE TX 79601 TAYLOR 3256705151
452031 MEMORIAL SPECIALTY HOSPITAL 1201 FRANK ST SUITE D LUFKIN TX 75901 ANGELINA 9366397975 452032 CORNERSTONE HOSPITAL HOUSTON‐ CLEAR LAKE 709 MEDICAL CENTER BLVD WEBSTER TX 77598 HARRIS 7135515300 452033 TEXAS CENTER FOR INFECTIOUS DISEASE 2303 SE MILITARY DR P O BOX 23340 SAN ANTONIO TX 78223 BEXAR 2105348857 452034 CORNERSTONE HOSPITAL AUSTIN 4207 BURNET RD AUSTIN TX 78756 TRAVIS 5127061900 452035 MESA HILLS SPECIALTY HOSPITAL 2311 N OREGON STREET EL PASO TX 79902 EL PASO 9155481823 452038 TEXAS NEURO REHABILITATION CENTER 1106 W DITTMAR AUSTIN TX 78745 TRAVIS 5124444835 452039 KINDRED HOSPITAL 11297 FALLBROOK HOUSTON TX 77065 HARRIS 2818978114 452040 ACUITY HOSPITAL OF SOUTH TEXAS 718 LEXINGTON AVENUE SAN ANTONIO TX 78212 BEXAR 2105724600 452041 CARRUS SPECIALTY HOSPITAL 1810 WEST HIGHWAY 82 SHERMAN TX 75092 GRAYSON 9034164441 452042 CHRISTUS DUBUIS HOSPITAL OF BEAUMONT 2830 CALDER AVENUE 4TH FLOOR BEAUMONT TX 77702 JEFFERSON 4098997680 452043 PINE VALLEY SPECIALTY HOSPITAL 6160 S LOOP EAST HOUSTON TX 77087 HARRIS 7136402400 452044 LIFECARE HOSPITALS OF DALLAS 1950 RECORD CROSSING DALLAS TX 75235 DALLAS 2145256300 452046 PLAZA SPECIALTY HOSP 1300 BINZ HOUSTON TX 77004 HARRIS 7132851000 452049 SELECT SPECIALTY HOSPITAL‐HOUSTON ( MEMORIAL CITY) 1917 ASHLAND HOUSTON TX 77008 HARRIS 7138616161
452051 ETMC SPECIALTY 1000 S BECKHAM 5TH FLOOR TYLER TX 75701 SMITH 9035356551 452054 PLANO SPECIALTY HOSPITAL 1621 COIT ROAD PLANO TX 75075 COLLIN 9727585200 452055 CORNERSTONE HOSPITAL MEDICAL CENTER 2001 HERMANN DRIVE HOUSTON TX 77004 HARRIS 8326496200
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 209 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 452056 POST ACUTE MEDICAL SPECIALTY HOSPITAL OF VICTORIA 506 E SAN ANTONIO STREET 3 EAST FLOOR VICTORIA TX 77901 VICTORIA 3615751445
452057 NEXUS SPECIALTY HOSPITAL THE WOODLANDS 9182 SIX PINES DRIVE THE WOODLANDS TX 77380 MONTGOMERY 7133640317 452059 LIFECARE HOSPITAL OF SAN ANTONIO 8902 FLOYD CURL DRIVE SAN ANTONIO TX 78240 BEXAR 2106907000 452060 VIBRA HOSPITAL OF AMARILLO 7500 WALLACE BLVD AMARILLO TX 79120 POTTER 8063511600 452061 POST ACUTE MEDICAL SPECIALTY HOSPITAL OF TEXARKANA 2400 ST MICHAEL DRIVE 2ND FLOOR TEXARKANA TX 75503 BOWIE 9036147600
452062 WARM SPRING SPECIALITY HOSPTIAL AT LULING 200 MEMORIAL DRIVE LULING TX 78648 CALDWELL 5126726592 452063 LIFECARE HOSPITALS OF SOUTH TX 2001 M STREET MC ALLEN TX 78504 HIDALGO 9569267000 452066 PLUM CREEK SPECIALTY HOSPITAL 5601 PLUM CREEK DRIVE AMARILLO TX 79124 POTTER 8063511000 452067 PROMISE HOSPITAL OF DALLAS 7955 HARRY HINES BLVD DALLAS TX 75235 DALLAS 2146370000 452068 PROMISE HOSPITAL OF WICHITA FALLS 1103 GRACE STREET WICHITA FALLS TX 76301 WICHITA 9407637901 452071 KINDRED HOSPITAL‐WHITE ROCK 9440 POPPY DRIVE 5TH FLOOR DALLAS TX 75218 DALLAS 2143246730 452073 KINDRED HOSPITAL‐ SAN ANTONIO CENTRAL 111 DALLAS STREET 4TH FLOOR SAN ANTONIO TX 78205 BEXAR 2102977182 452074 KINDRED HOSPITAL TOMBALL 505 GRAHAM DRIVE TOMBALL TX 77375 HARRIS 2817652622 452075 KINDRED HOSPITAL CLEAR LAKE 350 BLOSSOM ST WEBSTER TX 77598 HARRIS 2813167800 452078 SELECT SPECIALTY HOSPITAL SOUTH DALLAS 3500 WEST WHEATLAND ROAD 4TH FLOOR DALLAS TX 75237 DALLAS 9727806506 452079 KINDRED HOSPTIAL EL PASO 1740 CURIE DRIVE EL PASO TX 79902 EL PASO 9153519044 452080 KINDRED HOSPITAL SUGAR LAND 1550 FIRST COLONY BOULEVARD SUGAR LAND TX 77479 FORT BEND 2812756000 452082 DUBUIS HOSPITAL OF PARIS 820 CLARKSVILLE ST 6TH FLOOR PARIS TX 75460 LAMAR 9037822961 452083 MID‐JEFFERSON EXTENDED CARE HOSPITAL 2600 HWY 365 NEDERLAND TX 77627 JEFFERSON 4097268700 452086 POST ACUTE MEDICAL SPECIALTY HOSPITAL CORPUS CH 600 ELIZABETH STREET 3RD FLOOR CORPUS CHRISTI TX 78404 NUECES 3618813223
452087 SELECT SPECIALITY HOSPITAL OF LONGVIEW 700 EAST MARSHALL AVE FIRST FLOOR WEST WING LONGVIEW TX 75601 GREGG 9033151111 452088 KINDRED HOSPITAL FORT WORTH 815 EIGHTH AVENUE FORT WORTH TX 76104 TARRANT 8173324812 452090 WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO 7400 BARLITE BLVD 2ND FLOOR SAN ANTONIO TX 78224 BEXAR 2109213550
452091 TYLER CONTINUECARE HOSPITAL (AT MOTHER FRANCES) 800 EAST DAWSON 4TH FLOOR TYLER TX 75701 SMITH 9035314942
452092 PAM SPECIALTY HOSPITAL OF CORPUS CHRISTI SOUTH 6226 SARATOGA BOULEVARD CORPUS CHRISTI TX 78414 NUECES 3619861600
452094 WARM SPRINGS SPECIALTY HOSPITAL OF VICTORIA LLC 102 MEDICAL DRIVE VICTORIA TX 77904 VICTORIA 3615766200
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 210 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 452095 SOLARA HOSPITAL MCALLEN 301 WEST EXPRESSWAY 83‐8TH FLOOR MC ALLEN TX 78503 HIDALGO 9566324880 452096 LAREDO SPECIALTY HOSPITAL LP 2005 BUSTAMANTE STREET LAREDO TX 78041 WEBB 9567535353 452097 VIBRA SPECIALTY HOSPITAL 2700 WALKER WAY DE SOTO TX 75115 DALLAS 2146381500 452100 MESQUITE SPECIALTY HOSPITAL 1024 N GALLOWAY AVENUE MESQUITE TX 75149 DALLAS 9722162300 452101 SOLARA HOSPITAL HARLINGEN 508 VICTORIA LANE HARLINGEN TX 78550 CAMERON 6828319670 452102 COVENANT SPECIALTY HOSPITAL 3815 20TH STREET LUBBOCK TX 79410 LUBBOCK 8067259200 452103 EL PASO LTAC HOSPTIAL 1221 N COTTON ST 3RD FLOOR EL PASO TX 79902 EL PASO 9154969687 452105 BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL 546 N KEGLEY ROAD TEMPLE TX 76502 BELL 2542150900
452106 WARM SPRINGS SPECIALTY HOSPITAL AT NEW BRAUNFELS 1445 HANZ DRIVE NEW BRAUNFELS TX 78130 COMAL 8306277600
452107 CORNERSTONE HOSPITAL CONROE 1500 GRAND LAKE DRIVE CONROE TX 77304 MONTGOMERY 6828319670 452108 DALLAS LTACH LLC 8050 MEADOWS ROAD DALLAS TX 75231 DALLAS 4692326500 452109 INTEGRITY TRANSITIONAL HOSPITAL 2813 SOUTH MAYHILL ROAD DENTON TX 76208 DENTON 8167292740 452110 ETHICUS HOSPITAL ‐ GRAPEVINE 4201 WILLIAM D TATE AVENUE GRAPEVINE TX 76051 TARRANT 8172881300 452111 ATRIUM MEDICAL CENTER AT CORINTH 3305 CORINTH PARKWAY CORINTH TX 76208 DENTON 9402704100 452112 ICON HOSPITAL 19211 MCKAY BLVD HUMBLE TX 77338 HARRIS 7048877283 452113 CHRISTUS DUBUIS HOSPITAL OF BRYAN 1600 JOSEPH DRIVE, 2ND FLOOR BRYAN TX 77802 BRAZOS 9798217592 452114 ATRIUM MEDICAL CENTER 11929 W AIRPORT BLVD, SUITE 110 STAFFORD TX 77477 FORT BEND 2812078200 452117 CONTINUECARE HOSPITTAL AT MIDLAND MEMORIAL 4214 ANDREWS HIGHWAY MIDLAND TX 79703 MIDLAND 4322211111 452118 HOUSTON METHODIST ST CATHERINE HOSPITAL 701 S FRY ROAD KATY TX 77450 HARRIS 2815995700 452119 SELECT SPECIALTY HOSPITAL DALLAS DOWNTOWN 3500 GASTON AVENUE 3RD AND 4TH FLOORS DALLAS TX 75246 DALLAS 9722270093 452120 SELECT SPECIALTY HOSPITAL DALLAS GARLAND 2300 MARIE CURIE 3W AND 3E GARLAND TX 75042 DALLAS 4693340853 453025 TIRR MEMORIAL HERMANN 1333 MOURSUND AVE HOUSTON TX 77030 HARRIS 7137997022 453029 HEALTHSOUTH REHABILITATION HOSPITAL OF HUMBLE 19002 MCKAY DRIVE HUMBLE TX 77338 HARRIS 2813199509
453031 HEALTHSOUTH REHAB INSTITUTE OF SAN ANTONIO 9119 CINNAMON HILL SAN ANTONIO TX 78240 BEXAR 2106910737 453035 WARM SPRINGS REHAB HOSPITAL OF SAN ANTONIO LLC 5101 MEDICAL DR SAN ANTONIO TX 78229 BEXAR 2106160100
453036 BAYLOR INSTITUTE FOR REHABILITATION 909 NORTH WASHINGTON AVENUE DALLAS TX 75246 DALLAS 2148209543 453040 HEALTHSOUTH REHABILITATION HOSPITAL OF ARLINGTON 3200 MATLOCK ARLINGTON TX 76015 TARRANT 8174684000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 211 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 453041 HEALTHSOUTH REHABILITATION HOSPITAL OF FORT 1212 WEST LANCASTER FORT WORTH TX 76102 TARRANT 8178702336 WORTH 453042 HEALTHSOUTH CITY VIEW REHAB HOSPITAL 6701 OAKMONT BOULEVARD FORT WORTH TX 76132 TARRANT 8173704700 453047 HEALTHSOUTH PLANO REHABILITATION HOSPITAL 2800 W 15TH ST PLANO TX 75075 COLLIN 9726129000 453048 PAM REHABILITATION HOSPITAL OF BEAUMONT 3340 PLAZA 10 BLVD STE B BEAUMONT TX 77707 JEFFERSON 4098350835 453052 KINDRED REHABILITATION HOSPITAL CLEAR LAKE 655 E MEDICAL CENTER BLVD WEBSTER TX 77598 HARRIS 2812861500 453053 HEALTHSOUTH REHABILITATION HOSPITAL OF TEXARKANA 515 WEST 12TH ST TEXARKANA TX 75501 BOWIE 9037930088
453054 HEALTHSOUTH REHAB HOSPITAL OF WICHITA FALLS 3901 ARMORY ROAD WICHITA FALLS TX 76301 WICHITA 9407205700 453056 TRINITY MOTHER FRANCES REHABILITATION HOSPITAL 3131 TROUP HWY TYLER TX 75701 SMITH 9035107000
453057 HEALTHSOUTH REHABILITATION OF MIDLAND ODESSA 1800 HERITAGE BOULEVARD MIDLAND TX 79707 MIDLAND 9155201600
453059 HEALTHSOUTH REHAB HOSPITAL THE WOODLANDS 18550 I 45 SOUTH CONROE TX 77384 MONTGOMERY 2813643304 453065 CHRISTUS ST MICHAEL REHAB HOSPITAL 2400 ST MICHAEL DRIVE TEXARKANA TX 75503 BOWIE 9036144000 453072 ETMC REHAB 701 OLYMPIC PLAZA CIRCLE TYLER TX 75701 SMITH 9035963000 453086 HIGHLANDS REHABILITATION HOSPITAL 1395 GEORGE DIETER DRIVE EL PASO TX 79936 EL PASO 9152987222 453091 WESLACO REGIONAL REHABILITATION HOSPITAL LLC 906 JAMES STREET WESLACO TX 78596 HIDALGO 9569692222 453092 SOUTH TEXAS REHABILTATION HOSPITAL 425 EAST ALTON GLOOR BLVD BROWNSVILLE TX 78526 CAMERON 9565546000 453094 KINDRED REHABILITATION HOSPITAL ARLINGTON 2601 WEST RANDOL MILL ROAD # 101 ARLINGTON TX 76012 TARRANT 8178044410 453096 VIBRA REHABILITATION HOSPITAL OF AMARILLO 7200 WEST 9TH STREET AMARILLO TX 79106 POTTER 8064682981 453300 COOK CHILDRENS MEDICAL CENTER 801 SEVENTH AVENUE FORT WORTH TX 76104 TARRANT 6828854000 453301 DRISCOLL CHILDRENS HOSPITAL 3533 S ALAMEDA BOX 6530 CORPUS CHRISTI TX 78411 NUECES 3617394846 453302 CHILDRENS MEDICAL CTR OF DALLAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 DALLAS 2144567000 453304 TEXAS CHILDRENS HOSP 6621 FANNIN STREET HOUSTON TX 77030 HARRIS 8328241000 453306 COVENANT CHILDRENS HOSPITAL 4015 22ND PLACE LUBBOCK TX 79410 LUBBOCK 8067250532 453308 OUR CHILDRENS HOUSE 8 PRESTIGE CIRCLE 101 ALLEN TX 75002 COLLIN 2148284747 453309 HEALTHBRIDGE CHILDRENS'S HOSPITAL OF HOUSTON 2929 WOODLAND PARK DRIVE HOUSTON TX 77082 HARRIS 2812937774
453310 DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS 4900 MUELLER BLVD AUSTIN TX 78723 TRAVIS 5123240000
453311 SHRINERS HOSPITALS FOR CHILDREN 815 MARKET STREET GALVESTON TX 77550 GALVESTON 4097706600 453312 SHRINERS HOSPITALS FOR CHILDREN 6977 MAIN STREET HOUSTON TX 77030 HARRIS 7137971616
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 212 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 453313 EL PASO CHILDREN'S HOSPITAL 4845 ALAMEDA AVENUE EL PASO TX 79905 EL PASO 9155217148 453314 TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN 2222 WELBORN STREET DALLAS TX 75219 DALLAS 2145595000 453315 CHILDREN'S HOSPITAL OF SAN ANTONIO 333 NORTH SANTA ROSA STREET SAN ANTONIO TX 78207 BEXAR 2107043342 453316 CHILDRENS MEDICAL CENTER PLANO 7601 PRESTON ROAD PLANO TX 75024 COLLIN 2144561792 454000 BIG SPRING STATE HOSPITAL 1901 NORTH HIGHWAY 87 BIG SPRING TX 79721 HOWARD 4322687222 454006 TERRELL STATE HOSPITAL 1200 E BRIN STREET TERRELL TX 75160 KAUFMAN 9725246452 454008 NORTH TEXAS STATE HOSPITAL 6515 KEMP BLVD WICHITA FALLS TX 76308 WICHITA 9406921220 454009 RUSK STATE HOSP 805 N DICKINSON DR RUSK TX 75785 CHEROKEE 9036833421 454011 SAN ANTONIO STATE HOSP STATE SCHOOL 6711 S NEW BRAUNFELS AVE SAN ANTONIO TX 78223 BEXAR 2105317711 454012 MILLWOOD HOSPITAL 1011 NORTH COOPER STREET ARLINGTON TX 76011 TARRANT 8172613121 454014 KERRVILLE STATE HOSP 721 THOMPSON DR KERRVILLE TX 78028 KERR 8308962211 454018 RED RIVER HOSPITAL 1505 8TH ST WICHITA FALLS TX 76301 WICHITA 9403223171 454026 WEST OAKS HOSPITAL 6500 HORNWOOD HOUSTON TX 77074 HARRIS 7139950909 454029 SETON SHOAL CREEK HOSPITAL 3501 MILLS AVE AUSTIN TX 78731 TRAVIS 5123242000 454050 GLEN OAKS HOSPITAL 301 E DIVISION BOX 1885 GREENVILLE TX 75401 HUNT 9034546000 454060 LAUREL RIDGE TREATMENT CENTER 17720 CORPORATE WOODS DRIVE SAN ANTONIO TX 78259 BEXAR 5124919400 454064 RIVER CREST HOSP 1636 HUNTERS GLEN ROAD SAN ANGELO TX 76901 TOM GREEN 9159495722 454065 HICKORY TRAIL HOSPITAL 2000 N OLD HICKORY TRAIL DESOTO TX 75115 DALLAS 9722987323 454069 AUSTIN LAKES HOSPITAL 1025 EAST 32ND STREET AUSTIN TX 78705 TRAVIS 5128675800 454076 HARRIS CTY PSYCHIATRIC CTR 2800 MACGREGOR WAY HOUSTON TX 77021 HARRIS 7137415000 454083 INTRACARE NORTH HOSPITAL 1120 CYPRESS STATION DR HOUSTON TX 77090 HARRIS 2818937200 454084 AUSTIN STATE HOSPITAL 4110 GUADALUPE AUSTIN TX 78751 TRAVIS 5124192100 454085 DEVEREUX TEXAS TREATMENT NETWORK 1150 DEVEREUX DR LEAGUE CITY TX 77573 GALVESTON 2813351000 454088 RIO GRANDE STATE CENTER 1401 RANGERVILLE ROAD HARLINGEN TX 78550 CAMERON 9563648000 454093 SUNRISE CANYON HOSPITAL 1950 ASPEN AVENUE LUBBOCK TX 79408 LUBBOCK 8067660268 454094 GREEN OAKS HOSPITAL 7808 CLODUS FIELDS DRIVE DALLAS TX 75251 DALLAS 9729919504 454098 ABILENE BEHAVIORAL HEALTH LLC 4225 WOODS PLACE ABILENE TX 79608 TAYLOR 3256986600 454100 EL PASO PSYCHIATRIC CENTER 4615 ALAMEDA AVENUE EL PASO TX 79905 EL PASO 9155322202 454101 ALLEGIANCE BEHAVIORAL HEALTH CENTER OF PLAINVIEW 2601 DIMMITT ROAD, SUITE 400 PLAINVIEW TX 79072 HALE 8062969191
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 213 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 454103 KINGWOOD PINES HOSPITAL 2001 LADBROOK KINGWOOD TX 77339 HARRIS 2813581495 454104 UNIVERSITY BEHAVIORAL HEALTH 2026 WEST UNIVERSITY DRIVE DENTON TX 76201 DENTON 9403208100 454107 BEHAVIORAL HOSPITAL OF BELLAIRE 5314 DASHWOOD, SUITE 200 HOUSTON TX 77081 HARRIS 7136009500 454108 CYPRESS CREEK HOSPITAL 17750 CALI DRIVE HOUSTON TX 77090 HARRIS 2815867600 454109 EL PASO BEHAVIORAL HEALTH SYSTEM 1900 DENVER AVE EL PASO TX 79902 EL PASO 9155444000 454110 OCEANS BEHAVIORAL HOSPITAL OF PERMIAN BASIN 3300 S FM 1788 MIDLAND TX 79706 MIDLAND 4325615915 454111 TEXAS STAR RECOVERY 1106 WEST DITTMAR RD AUSTIN TX 78745 TRAVIS 5124444835 454113 SUNDANCE HOSPITAL 7000 US HIGHWAY 287 ARLINGTON TX 76001 TARRANT 8175838080 454114 CEDAR CREST HOSPITAL & RTC 3500 SOUTH IH‐35 BELTON TX 76513 BELL 2549392100 454117 OCEANS BEHAVIORAL HOSPITAL OF LONGVIEW 615 CLINIC DR LONGVIEW TX 75605 GREGG 9032123105 454118 LONE STAR BEHAVIORAL HEALTH CYPRESS 16303 GRANT ROAD CYPRESS TX 77429 HARRIS 2815166186 454119 CARROLLTON SPRINGS 2225 PARKER ROAD CARROLLTON TX 75010 DENTON 9722424114 454121 AUSTIN OAKS HOSPITAL 1407 WEST STASSNEY LANE AUSTIN TX 78745 TRAVIS 5123838939 454122 OCEANS BEHAVIORAL HOSPITAL OF ABILENE 6401 DIRECTORS PARKWAY ABILENE TX 79606 TAYLOR 3296910030 454123 OCEANS BEHAVIORAL HOSPITAL OF LUFKIN LLC 302 GOBBLERS KNOB RD LUFKIN TX 75904 ANGELINA 9366322276 454124 MESA SPRINGS 5560 MESA SPRINGS DRIVE FORT WORTH TX 76123 TARRANT 8172924600 454125 ROCK PRAIRIE BEHAVIORAL HEALTH 3550 NORMAND DRIVE COLLEGE STATION TX 77845 BRAZOS 9797038848 454126 DALLAS BEHAVIORAL HEALTHCARE HOSPITAL LLC 800 KIRNWOOD DRIVE DE SOTO TX 75115 DALLAS 9722961005 454128 OCEANS BEHAVIORAL HOSPITAL OF FORT WORTH 6200 OVERTON RIDGE BLVD FORT WORTH TX 76132 TARRANT 8173611991 454129 GEORGETOWN BEHAVIORAL HEALTH INSTITUTE 3101 S AUSTIN AVENUE GEORGETOWN TX 78626 WILLIAMSON 2489055091 454130 OCEANS BEHAVIORAL HOSPITAL OF PLANO 4301 MAPLESHADE LANE PLANO TX 75093 COLLIN 9725965445 454131 WESTPARK SPRINGS LLC 6902 S PEEK ROAD RICHMOND TX 77407 FORT BEND 8325352770 454132 SAN ANTONIO BEHAVIORAL HEALTHCARE HOSPITAL 8550 HUEBNER ROAD SAN ANTONIO TX 78240 BEXAR 2105415300 454133 CROSS CREEK HOSPITAL 8402 CROSS PARK DRIVE AUSTIN TX 78754 TRAVIS 8445724956 454134 HAVEN BEHAVIORAL HOSPITAL OF FRISCO 5680 FRISCO SQUARE BLVD, SUITE 3000 FRISCO TX 75034 COLLIN 4695358000 454135 HOUSTON BEHAVIORAL HEALTHCARE HOSPITAL LLC 2801 GESSNER ROAD HOUSTON TX 77080 HARRIS 8328347710 454136 OCEANS BEHAVIORAL HOSPITAL OF KATY 455 PARK GROVE LANE KATY TX 77450 HARRIS 2814928888 454137 OCEANS BEHAVIORAL HOSPITAL OF SAN MARCOS 1106 N IH 35 SAN MARCOS TX 78666 HAYS 5123530914 454138 GARLAND BEHAVIORAL HOSPITAL 2300 MARIE CURIE BLVD 5TH FLOOR GARLAND TX 75042 DALLAS 9724875309 454139 SUN BEHAVIORAL HOUSTON 7601 FANNIN STREET HOUSTON TX 77054 HARRIS 7137955025
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 214 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 459801 MEDICAL CITY HOSPITAL 7777 FOREST LANE DALLAS TX 75230 DALLAS 9725667199 459802 METHODIST DALLAS MEDICAL CENTER 1441 N BECKLEY AVENUE DALLAS TX 75203 DALLAS 2149472879 459803 UNIVERSITY HOSPITAL TRANSPLANT 4502 MEDICAL DRIVE SAN ANTONIO TX 78229 BEXAR 2105675772 459805 ST LUKES EPISCOPAL HOSPITAL TRANSPLANT 6720 BERTNER HOUSTON TX 77030 HARRIS 8323551000 459806 CHRISTUS SANTA ROSA MEDICAL CENTER TRANSPLANT 333 SANTA ROSA STREET SAN ANTONIO TX 78207 BEXAR 2108889999
459807 NORTH AUSTIN MEDICAL CENTER 12221 NORTH MOPAC EXPRESSWAY AUSTIN TX 78758 TRAVIS 5129012896 459808 BAYLOR UNIVERSITY MEDICAL CENTER 3500 GASTON AVE DALLAS TX 75246 DALLAS 2148202657 459809 THE METHODIST HOSPITAL TRANSPLANT 6565 FANNIN HOUSTON TX 77030 HARRIS 7137902221 459810 SETON MEDICAL CENTER 1201 WEST 38TH STREET AUSTIN TX 78705 TRAVIS 5123241902 459811 HARRIS METHODIST FT WORTH TRANSPLANT 1301 PENNSYLVANIA AVE FORT WORTH TX 76104 TARRANT 8178822100 459812 COOK CHILDRENS MEDICAL CENTER TRANSPLANT SERVICES 801 SEVENTH AVE FORT WORTH TX 76104 TARRANT 6828854286
459813 UTMB GALVESTON TRANSPLANT 301 UNIVERSITY BLVD GALVESTON TX 77555 GALVESTON 4097728643 459814 CHILDREN'S MEDICAL CENTER DALLAS 1935 MOTOR ST DALLAS TX 75235 DALLAS 2144566332 459815 TEXAS CHILDREN'S HOSPITAL TRANSPLANT 6621 FANNIN HOUSTON TX 77030 HARRIS 8328241120 459816 UT SOUTHWESTERN MEDICAL CENTER UNIVERSITY 5909 HARRY HINES BLVD DALLAS TX 75390 DALLAS 2146451914 HOSPITAL 459817 EAST TEXAS MEDICAL CENTER TRANSPLANT 1000 S BECKHAM TYLER TX 75701 SMITH 9035318643 459818 METHODIST HOSPITAL 7700 FLOYD CURL DRIVE SAN ANTONIO TX 78229 BEXAR 2105756275 459819 PARKLAND HOSPITAL 5201 HARRY HINES DALLAS TX 75235 DALLAS 2145906773 459821 SCOTT & WHITE TRANSPLANT 2401 S 31ST ST TEMPLE TX 76508 BELL 2547247545 459822 BAYLOR ALL SAINTS MEDICAL CENTER OF FORT WORTH 1400 EIGHTH AVE FORT WORTH TX 76104 TARRANT 8179224650
459823 DRISCOLL CHILDREN'S HOSPITAL TRANSPLANT CENTER 3533 S ALAMEDA CORPUS CHRISTI TX 78466 NUECES 3616946852
459824 MEMORIAL HERMANN HOSPITAL 6411 FANNIN DRIVE HOUSTON TX 77030 HARRIS 7137041735 459825 LAS PALMAS MEDICAL CENTER (TRANSPLANT) 1700 NORTH OREGON, SUITE 680 EL PASO TX 79902 EL PASO 9155211828 459826 PLAZA MEDICAL CENTER OF FORT WORTH 900 EIGHTH AVENUE FORT WORTH TX 76104 TARRANT 8178775292 460001 UTAH VALLEY HOSPITAL 1034 NORTH 500 WEST PROVO UT 84604 UTAH 8013737850 460003 SALT LAKE REGIONAL MEDICAL CENTER 1050 EAST SOUTH TEMPLE SALT LAKE CITY UT 84102 SALT LAKE 8013504111 460004 MCKAY DEE HOSPITAL 4401 HARRISON BOULEVARD OGDEN UT 84403 WEBER 8013872800
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 215 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 460005 OGDEN REGIONAL MEDICAL CENTER 5475 SOUTH 500 EAST OGDEN UT 84405 WEBER 8014792111 460006 LDS HOSPITAL 8TH AVENUE AND C STREET SALT LAKE CITY UT 84143 SALT LAKE 8014081100 460007 CEDAR CITY HOSPITAL 1303 NORTH MAIN STREET CEDAR CITY UT 84721 IRON 4358685800 460009 UNIVERSITY HEALTH CARE/UNIV HOSPITALS AND CLINICS 50 NORTH MEDICAL DRIVE SALT LAKE CITY UT 84132 SALT LAKE 8015812121
460010 INTERMOUNTAIN MEDICAL CENTER 5121 SOUTH COTTONWOOD STREET MURRAY UT 84107 SALT LAKE 8015077000 460011 CASTLEVIEW HOSPITAL 300 NORTH HOSPITAL DRIVE PRICE UT 84501 CARBON 4356374800 460013 MOUNTAIN VIEW HOSPITAL 1000 EAST 100 NORTH PAYSON UT 84651 UTAH 8014657100 460014 MOUNTAIN WEST MEDICAL CENTER 2055 NORTH MAIN STREET TOOELE UT 84074 TOOELE 4358433700 460015 LOGAN REGIONAL HOSPITAL 500 EAST 1400 NORTH LOGAN UT 84341 CACHE 4357161000 460017 BRIGHAM CITY COMMUNITY HOSPITAL 950 SOUTH MEDICAL DRIVE BRIGHAM CITY UT 84302 BOX ELDER 4357349471 460019 UINTAH BASIN MEDICAL CENTER 250 WEST 300 NORTH ROOSEVELT UT 84066 DUCHESNE 4357224691 460021 DIXIE REGIONAL MEDICAL CENTER 1380 EAST MEDICAL CENTER DRIVE ST GEORGE UT 84790 WASHINGTON 4352512100 460023 AMERICAN FORK HOSPITAL 170 NORTH 1100 EAST AMERICAN FORK UT 84003 UTAH 8018553305 460026 SEVIER VALLEY MEDICAL CENTER 1000 NORTH MAIN STREET RICHFIELD UT 84701 SEVIER 4358934100 46002F V A HOSPITAL 500 FOOTHILL DR SALT LAKE CITY UT 84113 SALT LAKE 8015821565 460030 ASHLEY REGIONAL MEDICAL CENTER 150 WEST 100 NORTH VERNAL UT 84078 UINTAH 4357893342 460033 GARFIELD MEMORIAL HOSPITAL 200 NORTH 400 EAST PANGUITCH UT 84759 GARFIELD 4356768811 460039 BEAR RIVER VALLEY HOSPITAL 905 NORTH 1000 WEST TREMONTON UT 84337 BOX ELDER 4352074500 46003F U S AIR FORCE HOSP HILL AIR FORCE BASE UT 84401 WEBER 460041 DAVIS HOSPITAL AND MEDICAL CENTER 1600 WEST ANTELOPE DRIVE LAYTON UT 84041 DAVIS 8018077001 460042 LAKEVIEW HOSPITAL 630 EAST MEDICAL DRIVE BOUNTIFUL UT 84010 DAVIS 8012992200 460043 OREM COMMUNITY HOSPITAL 331 NORTH 400 WEST OREM UT 84057 UTAH 8017143307 460044 ALTA VIEW HOSPITAL 9660 SOUTH 1300 EAST SANDY UT 84094 SALT LAKE 8015012600 460047 ST MARK'S HOSPITAL 1200 EAST 3900 SOUTH SALT LAKE CITY UT 84124 SALT LAKE 8012687700 460049 THE ORTHOPEDIC SPECIALTY HOSPITAL 5848 SOUTH 300 EAST MURRAY UT 84107 SALT LAKE 8013144100 46004F U S ARMY HOSPITAL DUGWAY PROVING GROUND DUGWAY UT 84022 TOOELE 4350000000 460051 JORDAN VALLEY MEDICAL CENTER 3580 WEST 9000 SOUTH WEST JORDAN UT 84088 SALT LAKE 8015618888 460052 TIMPANOGOS REGIONAL HOSPITAL 750 WEST 800 NORTH OREM UT 84057 UTAH 8017146800 460054 CACHE VALLEY HOSPITAL 2380 NORTH 400 EAST NORTH LOGAN UT 84341 CACHE 4357139700
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 216 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 460057 PARK CITY HOSPITAL 900 ROUND VALLEY DRIVE PARK CITY UT 84060 SUMMIT 4356586700 460058 RIVERTON HOSPITAL 3741 WEST 12600 SOUTH RIVERTON UT 84065 SALT LAKE 8012854000 460060 LONE PEAK HOSPITAL 11925 S STATE STREET DRAPER UT 84020 SALT LAKE 8015458000 461300 DELTA COMMUNITY MEDICAL CENTER 126 SOUTH WHITE SAGE AVENUE DELTA UT 84624 MILLARD 4358645591 461301 FILLMORE COMMUNITY MEDICAL CENTER 674 SOUTH HIGHWAY 99 FILLMORE UT 84631 MILLARD 4357435591 461302 MOAB REGIONAL HOSPITAL 450 WEST WILLIAMS WAY MOAB UT 84532 GRAND 4357193501 461303 SANPETE VALLEY HOSPITAL ‐ CAH 1100 SOUTH MEDICAL DRIVE MOUNT PLEASANT UT 84647 SANPETE 4354624123 461304 CENTRAL VALLEY MEDICAL CENTER ‐ CAH 48 WEST 1500 NORTH NEPHI UT 84648 JUAB 4356233000 461305 MILFORD VALLEY MEMORIAL HOSPITAL 850 NORTH MAIN STREET MILFORD UT 84751 BEAVER 4353872411 461306 GUNNISON VALLEY HOSPITAL 64 EAST 100 NORTH GUNNISON UT 84634 SANPETE 4355287246 461307 HEBER VALLEY MEDICAL CENTER 1485 SOUTH HIGHWAY 40 HEBER CITY UT 84032 WASATCH 4356542500 461308 SAN JUAN HOSPITAL 380 WEST 100 NORTH MONTICELLO UT 84535 SAN JUAN 4355872116 461309 KANE COUNTY HOSPITAL 355 NORTH MAIN STREET KANAB UT 84741 KANE 4356445811 461310 BLUE MOUNTAIN HOSPITAL 802 SOUTH 200 WEST BLANDING UT 84511 SAN JUAN 4356783993 461335 BEAVER VALLEY HOSPITAL 1109 NORTH 100 WEST BEAVER UT 84713 BEAVER 4354387100 462003 SPECIALTY HOSPITAL OF UTAH 401 SOUTH 400 EAST BOUNTIFUL UT 84010 DAVIS 8012952361 462004 PROMISE HOSPITAL OF SALT LAKE 8TH AVENUE C STREET SALT LAKE CITY UT 84143 SALT LAKE 8014087109 462005 UTAH VALLEY SPECIALTY HOSPITAL 306 WEST RIVER BEND LANE PROVO UT 84604 UTAH 8012268880 462006 LANDMARK HOSPITAL OF SALT LAKE CITY, LLC 4252 S BIRKHILL BLVD MURRAY UT 84107 SALT LAKE 8012685400 463025 HEALTHSOUTH REHABILITATION HOSPITAL OF UTAH 8074 SOUTH 1300 EAST SANDY UT 84094 SALT LAKE 8015613400 463027 NORTHERN UTAH REHABILITATION HOSPITAL 5825 HARRISON BOULEVARD SOUTH OGDEN UT 84403 WEBER 8014755254 463301 PRIMARY CHILDRENS HOSPITAL 100 NORTH MARIO CAPECCHI DRIVE SALT LAKE CITY UT 84113 SALT LAKE 8016626212 463302 SHRINERS HOSPITALS FOR CHILDREN ‐ S L C FAIRFAX ROAD AT VIRGINIA STREET SALT LAKE CITY UT 84103 SALT LAKE 8015363500 464001 UTAH STATE HOSPITAL 1300 EAST CENTER STREET PROVO UT 84605 WEBER 8013444400 464009 UNIVERSITY OF UTAH NEUROPSYCHIATRIC INSTITUTE 501 CHIPETA WAY SALT LAKE CITY UT 84108 SALT LAKE 8015832500 464012 MARIAN CENTER 451 EAST BISHOP FEDERAL LANE SALT LAKE CITY UT 84115 SALT LAKE 8014877557 464013 SALT LAKE BEHAVIORAL HEALTH 3802 SOUTH 700 EAST SALT LAKE CITY UT 84106 SALT LAKE 8012646000 464014 PROVO CANYON BEHAVIORAL HOSPITAL 1350 EAST 750 NORTH OREM UT 84097 UTAH 8018522273 464015 HIGHLAND RIDGE HOSPITAL 7309 SOUTH 180 WEST MIDVALE UT 84047 SALT LAKE 8015692153 469810 UNIVERSITY OF UTAH HOSPITAL ‐ TC 50 NORTH MEDICAL DRIVE SALT LAKE CITY UT 84132 SALT LAKE 8015812121
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 217 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 469811 INTERMOUNTAIN MEDICAL CENTER 5121 SOUTH COTTONWOOD STREET MURRAY UT 84107 SALT LAKE 8015074060 469812 PRIMARY CHILDRENS MEDICAL CENTER 100 NORTH MEDICAL DRIVE SALT LAKE CITY UT 84113 SALT LAKE 8016626513 470001 CENTRAL VERMONT MEDICAL CENTER BOX 547 BARRE VT 05641 WASHINGTON 8023714100 470003 UNIVERSITY OF VERMONT MEDICAL CENTER 111 COLCHESTER AVE BURLINGTON VT 05401 CHITTENDEN 8028470000 470005 RUTLAND REGIONAL MEDICAL CENTER 160 ALLEN ST RUTLAND VT 05701 RUTLAND 8027757111 470011 BRATTLEBORO MEMORIAL HOSPITAL 17 BELMONT AVE BRATTLEBORO VT 05301 WINDHAM 8022570341 470012 SOUTHWESTERN VERMONT MEDICAL CENTER 100 HOSPITAL DRIVE BENNINGTON VT 05201 BENNINGTON 8024426361 47001F VA HOSP NORTH HARTLAND RD WHITE RIVER JUNCTION VT 05001 WINDSOR 8022959363 470024 NORTHWESTERN MEDICAL CENTER INC 133 FAIRFIELD STREET SAINT ALBANS VT 05478 FRANKLIN 8025245911 471300 GRACE COTTAGE HOSPITAL PO BOX 216 TOWNSHEND VT 05353 WINDHAM 8023657920 471301 GIFFORD MEDICAL CENTER 44 SOUTH MAIN STREET RANDOLPH VT 05060 ORANGE 8027284441 471302 MT ASCUTNEY HOSPITAL 289 COUNTY ROAD WINDSOR VT 05089 WINDSOR 8026746711 471303 NORTHEASTERN VERMONT REGIONAL HOSPITAL 1315 HOSPITAL DRIVE SAINT JOHNSBURY VT 05819 CALEDONIA 8027487400 471304 NORTH COUNTRY HOSPITAL AND HEALTH CENTER 189 PROUTY DRIVE NEWPORT VT 05855 ORLEANS 8023347331 471305 COPLEY HOSPITAL 528 WASHINGTON HIGHWAY MORRISVILLE VT 05661 LAMOILLE 8028884231 471306 SPRINGFIELD HOSPITAL PO BOX 2003 SPRINGFIELD VT 05156 WINDSOR 8028852151 471307 PORTER HOSPITAL, INC 115 PORTER DRIVE MIDDLEBURY VT 05753 ADDISON 8023884701 474001 BRATTLEBORO RETREAT ANNA MARSH LANE PO BOX 803 BRATTLEBORO VT 05301 WINDHAM 8022577785 474004 VERMONT PSYCHIATRIC CARE HOSPITAL 350 FISHER ROAD BERLIN VT 05602 WASHINGTON 8028886770 479801 UNIVERSITY OF VERMONT MEDICAL CENTER ‐ TRANSPLANT 111 COLCHESTER AVENUE BURLINGTON VT 05401 CHITTENDEN 8028474771
480001 ROY LESTER SCHNEIDER HOSPITAL,THE 9048 SUGAR ESTATE ST THOMAS VI 00801 8097768311 480002 GOV JUAN F LUIS HOSPITAL & MEDICAL CTR #4007 EST DIAMOND RUBY, CHRISTIANSTED ST CROIX VI 00820 3407786311 490001 NORTON COMMUNITY HOSPITAL 100 15TH NW STREET NORTON VA 24273 7036798865 490002 RUSSELL COUNTY MEDICAL CENTER 58 CARROLL STREET LEBANON VA 24266 RUSSELL 2768838100 490004 SENTARA RMH MEDICAL CENTER 2010 HEALTH CAMPUS DRIVE HARRISONBURG VA 22801 5406891000 490005 WINCHESTER MEDICAL CENTER 1840 AMHERST ST WINCHESTER VA 22601 5405368000 490007 SENTARA NORFOLK GENERAL HOSPITAL 600 GRESHAM DR NORFOLK VA 23507 7573883000 490009 UNIVERSITY OF VIRGINIA MEDICAL CENTER JEFFERSON PARK AVE CHARLOTTESVILLE VA 22908 8002513627 490011 BON SECOURS DEPAUL MEDICAL CENTER 150 KINGSLEY LANE NORFOLK VA 23505 7578895000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 218 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 490013 SENTARA HALIFAX REGIONAL HOSPITAL 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 HALIFAX 4345173100 490017 BON SECOURS MARYVIEW MEDICAL CENTER 3636 HIGH STREET PORTSMOUTH VA 23707 7573982200 490018 AUGUSTA HEALTH 78 MEDICAL CENTER DRIVE FISHERSVILLE VA 22939 AUGUSTA 5409324000 490019 NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MED 501 SUNSET LANE CULPEPER VA 22701 CULPEPER 5408294100 CENTE 49001F DEWITT ARMY HOSP BUILDING 808 FORT BELVOIR VA 22060 FAIRFAX 490020 JOHN RANDOLPH MEDICAL CENTER 411 WEST RANDOLPH ROAD HOPEWELL VA 23860 8045411600 490021 CENTRA HEALTH, INC 1901 TATE SPRINGS ROAD LYNCHBURG VA 24501 4342004789 490022 MARY WASHINGTON HOSPITAL, INC 1001 SAM PERRY BOULEVARD FREDERICKSBURG VA 22401 5407411100 490023 FAUQUIER HOSPITAL 500 HOSPITAL DRIVE WARRENTON VA 20186 FAUQUIER 5403165000 490024 CARILION ROANOKE MEMORIAL HOSPITAL 1906 BELLEVIEW AVENUE, SE ROANOKE VA 24014 5409817000 49002F MC DONALD ARMY HOSP FT EUSTIS FORT EUSTIS VA 23604 490032 MEDICAL COLLEGE OF VIRGINIA HOSPITALS 1250 EAST MARSHALL STREET ‐ BOX 980510 RICHMOND VA 23298 8048280938 490033 WARREN MEMORIAL HOSPITAL 1000 NORTH SHENANDOAH AVE FRONT ROYAL VA 22630 WARREN 7036360300 490037 RIVERSIDE SHORE MEMORIAL HOSPITAL 9507 HOSPITAL AVENUE NASSAWADOX VA 23413 NORTHAMPTON 7574148000 490038 SMYTH COUNTY COMMUNITY HOSPITAL 245 MEDICAL PARK DRIVE MARION VA 24354 SMYTH 2763781000 490040 INOVA ALEXANDRIA HOSPITAL 4320 SEMINARY RD ALEXANDRIA VA 22304 7035043167 490041 MARY IMMACULATE HOSPITAL 2 BERNARDINE DRIVE NEWPORT NEWS VA 23602 7578866000 490042 CARILION NEW RIVER VALLEY MEDICAL CENTER 2900 LAMB CIRCLE CHRISTIANSBURG VA 24073 MONTGOMERY 5407312000 490043 INOVA LOUDOUN HOSPITAL 44045 RIVERSIDE PARKWAY LEESBURG VA 20176 LOUDOUN 7038586600 490044 SENTARA OBICI HOSPITAL 2800 GODWIN BOULEVARD SUFFOLK VA 23439 7579344000 490045 NOVANT HEALTH UVA PRINCE WILLIAM MEDICAL CENTER 8700 SUDLEY RD MANASSAS VA 20110 7033698000
490046 SENTARA LEIGH HOSPITAL 830 KEMPSVILLE ROAD NORFOLK VA 23502 7572616700 490048 LEWISGALE MEDICAL CENTER 1900 ELECTRIC ROAD SALEM VA 24153 5407764000 49004F US ARMY HOSP 82 INGALLS RD FORT MONROE VA 23651 490050 VIRGINIA HOSPITAL CENTER 1701 NORTH GEORGE MASON DRIVE ARLINGTON VA 22205 ARLINGTON 7035585000 490052 RIVERSIDE REGIONAL MEDICAL CENTER 500 J CLYDE MORRIS BLVD NEWPORT NEWS VA 23601 7575942000 490053 JOHNSTON MEMORIAL HOSPITAL 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 WASHINGTON 2762581000 490057 SENTARA VIRGINIA BEACH GENERAL HOSPITAL 1060 FIRST COLONIAL ROAD VIRGINIA BEACH VA 23454 7573958000 490059 BON SECOURS ST MARYS HOSPITAL 5801 BREMO RD RICHMOND VA 23226 HENRICO 8042852011
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 219 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 49005F US AIR FORCE HOSP LANGLEY AFB HAMPTON VA 23365 490060 CLINCH VALLEY MEDICAL CENTER 6801 GOVERNOR GC PERRY HIGHWAY RICHLANDS VA 24641 TAZEWELL 2765966000 490063 INOVA FAIRFAX HOSPITAL 3300 GALLOWS ROAD FALLS CHURCH VA 22042 FAIRFAX 7037764001 490066 SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER 100 SENTARA CIRCLE WILLIAMSBURG VA 23188 JAMES CITY 7579846000
490067 SOUTHSIDE REGIONAL MEDICAL CENTER 200 MEDICAL PARK BOULEVARD PETERSBURG VA 23805 8047655000 490069 BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER 8260 ATLEE ROAD MECHANICSVILLE VA 23116 HANOVER 8047646000
49006F HAMPTON VA MEDICAL CENTER 100 EMANCIPATION DRIVE HAMPTON VA 23667 7577229961 490075 DANVILLE REGIONAL MEDICAL CENTER 142 SOUTH MAIN STREET DANVILLE VA 24541 4347992100 490077 MARTHA JEFFERSON HOSPITAL 500 MARTHA JEFFERSON DRIVE CHARLOTTESVILLE VA 22911 ALBEMARLE 4346547000 490079 MEMORIAL HOSPITAL OF MARTINSVILLE & HENRY COUNTY 320 HOSPITAL DRIVE MARTINSVILLE VA 24115 HENRY 2766667200
49007F US PUBLIC HEALTH SERVICE HOSP 6500 HAMPTON BLVD NORFOLK VA 23508 490084 RIVERSIDE TAPPAHANNOCK HOSPITAL 618 HOSPITAL ROAD TAPPAHANNOCK VA 22560 ESSEX 8044436189 490088 BEDFORD MEMORIAL HOSPITAL 1613 OAKWOOD STREET BEDFORD VA 24523 BEDFORD 4342006366 490089 CARILION FRANKLIN MEMORIAL HOSPITAL 180 FLOYD AVENUE ROCKY MOUNT VA 24151 FRANKLIN 5404835277 49008F NAVAL MEDICAL CENTER PORTSMOUTH 620 JOHN PAUL JONES CIRCLE PORTSMOUTH VA 23708 7579535000 490090 SOUTHSIDE COMMUNITY HOSPITAL, INC 800 OAK STREET FARMVILLE VA 23901 PRINCE EDWARD 4343928811 490092 SOUTHAMPTON MEMORIAL HOSPITAL 100 FAIRVIEW DRIVE ‐ PO BOX 817 FRANKLIN VA 23851 7575696100 490093 SENTARA CAREPLEX HOSPITAL 3000 COLISEUM DRIVE HAMPTON VA 23666 7577361000 490094 BON SECOURS RICHMOND COMMUNITY HOSPITAL 1500 N. 28TH STREET RICHMOND VA 23223 8042251700 490097 SOUTHERN VIRGINIA REGIONAL MEDICAL CENTER 727 NORTH MAIN STREET EMPORIA VA 23847 4343484400 490098 COMMUNITY MEMORIAL HEALTHCENTER, INC 125 BUENA VISTA CIRCLE SOUTH HILL VA 23970 MECKLENBURG 4344473151 490101 INOVA FAIR OAKS HOSPITAL 3600 JOSEPH SIEWICK DRIVE FAIRFAX VA 22033 FAIRFAX 7033914170 490104 HIRAM W DAVIS MEDICAL CENTER P O BOX 4030 PETERSBURG VA 23803 8045247344 490107 RESTON HOSPITAL CENTER 1850 TOWN CENTER PARKWAY RESTON VA 20190 FAIRFAX 7036899000 49010F HUNTER HOLMES MCGUIRE VA MEDICAL CENTER 1201 BROAD ROCK BLVD RICHMOND VA 23249 8046755000 (RICHMOND) 490110 LEWISGALE HOSPITAL MONTGOMERY 3700 SOUTH MAIN STREET BLACKSBURG VA 24060 MONTGOMERY 5409511111 490111 WYTHE COUNTY COMMUNITY HOSPITAL 600 WEST RIDGE ROAD WYTHEVILLE VA 24382 WYTHE 2762280200 490112 CJW MEDICAL CENTER 7101 JAHNKE ROAD RICHMOND VA 23235 CHESTERFIELD 8043203911
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 220 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 490113 SENTARA NORTHERN VIRGINIA MEDICAL CENTER 2300 OPITZ BOULEVARD WOODBRIDGE VA 22191 PRINCE WILLIAM 7035231000 490114 LONESOME PINE HOSPITAL 1990 HOLTON AVENUE EAST BIG STONE GAP VA 24219 WISE 2765233111 490115 TWIN COUNTY REGIONAL HOSPITAL 200 HOSPITAL DRIVE GALAX VA 24333 2762368181 490116 LEWISGALE HOSPITAL PULASKI 2400 LEE HIGHWAY PULASKI VA 24301 PULASKI 5409948100 490117 CARILION TAZEWELL COMMUNITY HOSPITAL 141 BEN BOLT AVENUE TAZEWELL VA 24651 TAZEWELL 2769888700 490118 HENRICO DOCTORS' HOSPITAL 1602 SKIPWITH ROAD RICHMOND VA 23229 HENRICO 8042894500 490119 SENTARA PRINCESS ANNE HOSPITAL 2025 GLENN MITCHELL DRIVE VIRGINIA BEACH VA 23456 7575071520 49011F SALEM VA MEDICAL CENTER 1970 ROANOKE BLVD SALEM VA 24153 7039822463 490120 CHESAPEAKE GENERAL HOSPITAL 736 BATTLEFIELD BLVD, NORTH CHESAPEAKE VA 23320 7573128121 490122 INOVA MOUNT VERNON HOSPITAL 2501 PARKERS LANE ALEXANDRIA VA 22306 FAIRFAX 7036647000 490126 LEWISGALE HOSPITAL ALLEGHANY ONE ARH LANE ‐ PO BOX 7LOW MOOR VA 24457 ALLEGHANY 5408626011 490127 BUCHANAN GENERAL HOSPITAL 1535 SLATE CREEK ROAD GRUNDY VA 24614 BUCHANAN 2769351000 490129 HALQUIST MEMORIAL INPATIENT CENTER 4715 NORTH 15 STREET ARLINGTON VA 22205 ARLINGTON 7035257070 490130 RIVERSIDE WALTER REED HOSPITAL 7519 HOSPITAL ROAD GLOUCESTER VA 23061 GLOUCESTER 8046938800 490136 BON SECOURS ST FRANCIS MEDICAL CENTER 13710 ST FRANCIS BOULEVARD MIDLOTHIAN VA 23114 CHESTERFIELD 8045947400 490140 STAFFORD HOSPITAL, LLC 101 HOSPITAL CENTER BOULEVARD STAFFORD VA 22554 STAFFORD 5407419000 490141 SPOTSYLVANIA REGIONAL MEDICAL CENTER 4600 SPOTSYLVANIA PARKWAY FREDERICKSBURG VA 22408 SPOTSYLVANIA 5404984000 490143 RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG 1500 COMMONWEALTH AVENUE WILLIAMSBURG VA 23185 JAMES CITY 7573453000 490144 NOVANT HEALTH UVA HEALTH HAYMARKET MEDICAL 15225 HEALTHCOTE BOULEVARD HAYMARKET VA 20169 PRINCE WILLIAM 5712841000 CENTER 490145 STONESPRINGS HOSPITAL CENTER 24440 STONE SPRINGS BOULEVARD DULLES VA 20166 LOUDOUN 7038619284 49022E WESTBROOK PSYCHIATRIC HOSP 1500 WESTBROOK AVE RICHMOND VA 23227 HENRICO 49027E SALVATION ARMY HOME & HOSP 2705 5TH AVE RICHMOND VA 23220 49030E POAGES MILL CLINIC ROUTE 7 BOX 320 ROANOKE VA 24018 ROANOKE 49033E VIRGINIA TREATMENT CENTER FOR CHILDREN 515 NORTH 10TH STREET RICHMOND VA 23298 8048288822 49036E ST GERARDS MATERNITY HOME 2511 WISE ST RICHMOND VA 23227 HENRICO 49037E UNIVERSITY OF VIRGINIA CHILDRENS REHAB 2270 IVY ROAD CHARLOTTESVILLE VA 22901 ALBEMARLE 8002513627 491300 BATH COMMUNITY HOSPITAL 106 PARK DRIVE‐ PO DRAWER ZHOT SPRINGS VA 24445 BATH 5408397137 491302 CARILION GILES COMMUNITY HOSPITAL 159 HARTLEY WAY PEARISBURG VA 24134 GILES 5409216000 491303 DICKENSON COMMUNITY HOSPITAL 312 HOSPITAL DRIVE CLINTWOOD VA 24228 DICKENSON 2769260300
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 221 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 491304 CARILION STONEWALL JACKSON HOSPITAL 1 HEALTH CIRCLE LEXINGTON VA 24450 5404583503 491305 SHENANDOAH MEMORIAL HOSPITAL 759 SOUTH MAIN STREET WOODSTOCK VA 22664 SHENANDOAH 5404591100 491306 PIONEER HEALTH SERVICES OF PATRICK COUNTY,INC 18688 JEB STUART HIGHWAY STUART VA 24171 PATRICK 2766943151 491307 PAGE MEMORIAL HOSPITAL, INC 200 MEMORIAL DRIVE LURAY VA 22835 PAGE 5407434561 491308 RAPPAHANNOCK GENERAL HOSPITAL 101 HARRIS ROAD KILMARNOCK VA 22482 LANCASTER 8044358000 491991 LYNN HOUSE OF POTOMAC VALLEY 4400 WEST BRADDOCK ROAD ALEXANDRIA VA 22304 7033796000 492001 LAKE TAYLOR TRANSITIONAL CARE HOSPITAL 1309 KEMPSVILLE ROAD NORFOLK VA 23502 7574615001 492007 HOSPITAL FOR EXTENDED RECOVERY 600 GRESHAM DRIVE SUITE 700 NORFOLK VA 23507 7573881700 492008 HAMPTON ROADS SPECIALTY HOSPITAL 245 CHESAPEAKE AVENUE NEWPORT NEWS VA 23607 7575345000 492009 VIBRA HOSPITAL OF RICHMOND 2220 EDWARD HOLLAND DRIVE RICHMOND VA 23230 HENRICO 8046787000 492010 CENTRA SPECIALTY HOSPITAL 3300 RIVERMONT AVENUE, KRISE BUILDING, 5TH FLOOR LYNCHBURG VA 24503 4342001960
492011 UVA HEALTH SCIENCES CENTER 2965 IVY ROAD CHARLOTTESVILLE VA 22908 4349247897 493025 SHELTERING ARMS HOSPITAL 8254 ATLEE ROAD MECHANICSVILLE VA 23116 HANOVER 8043424320 493027 RIVERSIDE REHABILITATION INSTITUTE 245 CHESAPEAKE AVENUE NEWPORT NEWS VA 23607 7579288100 493028 HEALTHSOUTH REHABILITATION HOSPITAL OF VIRGINIA 5700 FITZHUGH AVENUE RICHMOND VA 23226 HENRICO 8042885700
493029 UNIVERSITY OF VIRGINIA ‐ HEALTHSOUTH, LLC 515 RAY C HUNT DRIVE CHARLOTTESVILLE VA 22903 4342442000 493030 SHELTERING ARMS HOSPITAL SOUTH 13700 SAINT FRANCIS BLVD SUITE 400 MIDLOTHIAN VA 23114 CHESTERFIELD 8043424320 493031 HEALTHSOUTH REHABILITATION HOSPITAL OF PETERSBURG 95 MEDICAL PARK BLVD PETERSBURG VA 23805 8045048100
493032 HEALTHSOUTH REHABILITATION HOSPITAL OF FREDERICKS 300 PARK HILL DRIVE FREDERICKSBURG VA 22401 5403687300
493033 HEALTHSOUTH REHABILITATION HOSPITAL OF NORTHERN 24430 MILLSTREAM DRIVE ALDIE VA 20105 LOUDOUN 7039572000 VA 493034 THE REHABILITATION HOSPITAL OF SOUTHWEST VA 103 NORTH STREET BRISTOL VA 24201 2766427900 493300 CUMBERLAND HOSPITAL LLC 9407 CUMBERLAND ROAD NEW KENT VA 23124 NEW KENT 8049662242 493301 CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC 601 CHILDREN'S LANE NORFOLK VA 23507 7576687000
493302 CHILDREN'S HOSP OF RICHMOND OF THE VCU HEALTH SYS 2924 BROOK ROAD RICHMOND VA 23220 8043217474
494010 NORTHERN VIRGINIA MENTAL HEALTH INSTI 3302 GALLOWS RD FALLS CHURCH VA 22042 FAIRFAX 7032077100 494017 SOUTHERN VIRGINIA MENTAL HEALTH INSTITUTE 382 TAYLOR DRIVE DANVILLE VA 24541 4347996220
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 222 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 494021 WESTERN STATE HOSPITAL 1301 RICHMOND ROAD STAUNTON VA 24402 5403328000 494022 POPLAR SPRINGS HOSPITAL 350 POPLAR DRIVE PO BOX 3060 PETERSBURG VA 23805 8047336874 494023 DOMINION HOSPITAL 2960 SLEEPY HOLLOW ROAD FALLS CHURCH VA 22044 FAIRFAX 7035362000 494025 VIRGINIA BEACH PSYCHIATRIC CENTER 1100 FIRST COLONIAL ROAD VIRGINIA BEACH VA 23454 7574966000 494029 SOUTHWESTERN VIRGINIA MENTAL HEALTH INSTITUTE 340 BAGLEY CIRCLE MARION VA 24354 SMYTH 2767831200
494032 THE PAVILION AT WILLIAMSBURG PLACE 5483 MOORETOWN ROAD WILLIAMSBURG VA 23188 JAMES CITY 7579416400 499800 SENTARA NORFOLK GENERAL HOSPITAL 600 GRESHAM DR NORFOLK VA 23507 7573888071 499801 INOVA FAIRFAX HOSPITAL 3300 GALLOWS ROAD FALLS CHURCH VA 22042 FAIRFAX 7039702600 499802 UNIVERSITY OF VIRGINIA HEALTH SYSTEM 1215 LESS STREET, PO BOX 800265 CHARLOTTESVILLE VA 22908 4342439308 499803 CHILDREN'S HOSP KINGS DAUGHTERS ‐ TRANSPLANT 601 CHILDREN'S LN NORFOLK VA 23507 7576687723 499804 HENRICO DOCTORS HOSPITAL ‐ TRANSPLANT 1602 SKIPWITH ROAD RICHMOND VA 23229 HENRICO 8042894800 499805 MEDICAL COLLEGE OF VIRGINIA 1200 E BROAD STREET, PO BOX 980510 RICHMOND VA 23298 8046282430 500001 NORTHWEST HOSPITAL 1550 NORTH 115TH STREET SEATTLE WA 98133 KING 2063681700 500002 PROVIDENCE ST MARY MEDICAL CENTER 401 W POPLAR ST WALLA WALLA WA 99362 WALLA WALLA 5095225900 500003 SKAGIT VALLEY HOSPITAL 1415 KINCAID STREET MOUNT VERNON WA 98274 SKAGIT 3604244111 500005 VIRGINIA MASON MEDICAL CENTER 925 SENECA ST SEATTLE WA 98101 KING 2062236867 500007 ISLAND HOSPITAL 1211 24TH STREET ANACORTES WA 98221 SKAGIT 3602991300 500008 UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST BOX 356151 SEATTLE WA 98195 KING 2065983300 500011 HIGHLINE MEDICAL CENTER 16251 SYLVESTER ROAD SW BURIEN WA 98166 KING 2062449970 500012 YAKIMA REGIONAL MEDICAL AND CARDIAC CENTER 110 SOUTH NINTH AVE YAKIMA WA 98902 YAKIMA 5095755102 500014 PROVIDENCE REGIONAL MEDICAL CENTER EVERETT 1321 COLBY AVENUE EVERETT WA 98201 SNOHOMISH 4252612000 500015 MULTICARE AUBURN MEDICAL CENTER 202 NORTH DIVISION STREET PLAZA ONE AUBURN WA 98001 KING 2538337711 500016 CENTRAL WASHINGTON HOSPITAL 1201 SOUTH MILLER STREET WENATCHEE WA 98807 CHELAN 5096621511 500019 PROVIDENCE CENTRALIA HOSPITAL 914 S SCHEUBER ROAD CENTRALIA WA 98531 LEWIS 3607362803 500021 ST CLARE HOSPITAL 11315 BRIDGEPORT WAY S W LAKEWOOD WA 98499 PIERCE 2535881711 500024 PROVIDENCE ST PETER HOSPITAL 413 LILLY ROAD NE OLYMPIA WA 98506 THURSTON 3604919480 500025 SWEDISH MEDICAL CENTER / CHERRY HILL 500 17TH AVENUE SEATTLE WA 98122 KING 2063202000 500026 SWEDISH EDMONDS HOSPITAL 21601 76TH AVENUE WEST EDMONDS WA 98026 SNOHOMISH 4256404000 500027 SWEDISH MEDICAL CENTER 747 BROADWAY SEATTLE WA 98122 KING 2063866000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 223 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 50002F US AIR FORCE HOSP FAIRCHILD AFB SPOKANE WA 99011 SPOKANE 500030 ST JOSEPH MEDICAL CENTER 2901 SQUALICUM PARKWAY BELLINGHAM WA 98225 WHATCOM 3607345400 500031 GRAYS HARBOR COMMUNITY HOSPITAL 915 ANDERSON DRIVE ABERDEEN WA 98520 GRAYS HARBOR 3605328330 500033 SAMARITAN HOSPITAL 801 EAST WHEELER ROAD MOSES LAKE WA 98837 GRANT 5097655606 500036 YAKIMA VALLEY MEMORIAL HOSPITAL 2811 TIETON DRIVE YAKIMA WA 98902 YAKIMA 5095758000 500037 TOPPENISH COMMUNITY HOSPITAL 502 W FOURTH AVE TOPPENISH WA 98948 YAKIMA 5098651520 500039 HARRISON MEMORIAL HOSPITAL 2520 CHERRY AVENUE BREMERTON WA 98310 KITSAP 3603773911 50003F US AIR FORCE HOSP LARSON AFB MOSES LAKE WA 98838 500041 PEACHEALTH ST JOHN MEDICAL CENTER 1615 DELAWARE STREET LONGVIEW WA 98632 COWLITZ 3604142000 500044 DEACONESS HOSPITAL W 800 FIFTH AVENUE SPOKANE WA 99210 SPOKANE 5094735800 500049 WALLA WALLA GENERAL HOSPITAL 1025 S SECOND AVE WALLA WALLA WA 99362 WALLA WALLA 5095250480 50004F US ARMY HOSP FT LAWTON ARMY BASE FORT LAWTON WA 98199 KING 500050 PEACEHEALTH SOUTHWEST MEDICAL CENTER 400 NE MOTHER JOSEPH PLACE VANCOUVER WA 98668 CLARK 3602562000 500051 OVERLAKE HOSPITAL MEDICAL CENTER 1035‐116TH AVE NE BELLEVUE WA 98004 KING 4256885000 500052 GROUP HEALTH CENTRAL HOSPITAL 201 ‐ 16TH AVENUE EAST SEATTLE WA 98112 KING 2063263000 500053 KENNEWICK GENERAL HOSPITAL 900 SOUTH AUBURN STREET KENNEWICK WA 99336 BENTON 5095866111 500054 PROVIDENCE SACRED HEART MEDICAL CENTER 101 WEST 8TH AVENUE SPOKANE WA 99204 SPOKANE 5094743040 500058 KADLEC REGIONAL MEDICAL CENTER 888 SWIFT BLVD RICHLAND WA 99352 BENTON 5099464611 50005F MADIGAN GEN HOSP TACOMA WA 98431 PIERCE 500060 CASCADE VALLEY HOSPITAL 330 S STILLAGUAMISH AVE ARLINGTON WA 98223 SNOHOMISH 3604352133 500064 HARBORVIEW MEDICAL CENTER 325 9TH AVENUE SEATTLE WA 98104 KING 2067313000 50006F US NAVAL HOSP 1 BOONE ROAD BREMERTON WA 98314 KITSAP 3604754000 500072 OLYMPIC MEDICAL CENTER 939 CAROLINE ST PORT ANGELES WA 98362 CLALLAM 3604177000 500077 PROVIDENCE HOLY FAMILY HOSPITAL 5633 NORTH LIDGERWOOD SPOKANE WA 99208 SPOKANE 5094822450 500079 MULTICARE GOOD SAMARITAN HOSPITAL 401 15TH AVENUE SE PUYALLUP WA 98372 PIERCE 2536972102 50007F US PUBLIC HEALTH SERVICE HOSP 1131 14TH AVE S SEATTLE WA 98114 KING 500084 EVERGREEN HEALTH MONROE 14701 179TH SE MONROE WA 98272 SNOHOMISH 3607947497 500088 VALLEY MEDICAL CENTER 400 S 43RD ST RENTON WA 98055 KING 4252283450 50008F US DEPARTMENT OF JUSTICE HOSP MC NEIL ISLAND STEILACOOM WA 98388 PIERCE 50009F VA HOSP AMERICAN LAKE WA 98493 PIERCE
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 224 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 500108 ST JOSEPH MEDICAL CENTER 1717 SOUTH J STREET TACOMA WA 98405 PIERCE 2536274101 50010F VA HOSP 4435 BEACON AVE S SEATTLE WA 98108 KING 500119 VALLEY HOSPITAL 12606 EAST MISSION AVENUE SPOKANE WA 99216 SPOKANE 5099246650 50011F VA HOSP 4815 N ASSEMBLY ST SPOKANE WA 99208 SPOKANE 500124 EVERGREENHEALTH MEDICAL CENTER 12040 NE 128TH STREET KIRKLAND WA 98034 KING 4258991000 500129 TACOMA GENERAL ALLENMORE HOSPITAL 315 S MLK JR WAY TACOMA WA 98415 PIERCE 2534031000 50012F VA HOSP VANCOUVER WA 98663 CLARK 500138 SEATTLE CANCER CARE ALLIANCE 825 EASTLAKE AVENUE EAST SEATTLE WA 98109 KING 2066675000 500139 CAPITAL MEDICAL CENTER 3900 CAPITAL MALL DR SW OLYMPIA WA 98502 THURSTON 3607545858 50013F VA HOSP WEST CHESTNUT ST WALLA WALLA WA 99362 WALLA WALLA 500141 ST FRANCIS COMMUNITY HOSPITAL 34515 9TH AVENUE SOUTH FEDERAL WAY WA 98003 KING 2539448100 500148 CONFLUENCE HEALTH‐ WENATCHEE VALLEY HOSP & 820 NORTH CHELAN AVENUE WENATCHEE WA 98801 CHELAN 5096638711 CLINICS 50014F US NAVAL HOSP US NAVAL AIR STATION WHIDBEY ISLAND OAK HARBOR WA 98277 ISLAND 500150 LEGACY SALMON CREEK MEDICAL CENTER 2211 NE 139TH STREET VANCOUVER WA 98686 CLARK 3604871000 500151 ST ANTHONY HOSPITAL 11567 CANTERWOOD BOULEVARD NW GIG HARBOR WA 98332 PIERCE 2535302050 500152 SWEDISH ISSAQUAH 751 NE BLAKELY DR ISSAQUAH WA 98029 KING 4253134000 50016E RALEIGH HILLS HOSP 1403 W 7TH AVE SPOKANE WA 99204 SPOKANE 50017E LAKELAND VILLAGE HOSP P O BOX 200 MEDICAL LAKE WA 99022 SPOKANE 50018E SHADEL HOSP 12001 AMBAUM BLVD SEATTLE WA 98146 KING 50019E SHRINERS HOSP FOR CRIPPLED CHILDREN 820 N SUMMIT BLVD SPOKANE WA 99201 SPOKANE 50020E PAULSEN MEDICAL‐DENTAL HOSP 407 W RIVERSIDE AVE SPOKANE WA 99201 SPOKANE 50024E FIRCREST SCHOOL HOSP SEATTLE WA 98155 KING 50025E YAKIMA VALLEY SCHOOL HOSP SELAH WA 98942 YAKIMA 50026E RANIER STATE SCHOOL HOSP BUCKLEY WA 98321 PIERCE 50028E ROSLYN‐CLE ELUM HOSP BOX 130 CLE ELUM WA 98922 KITTITAS 50029E ALCENAS HOSPITAL 10322 132 ND KIRKLAND WA 98033 KING 50030F VA PUGET SOUND HEALTH CARE SYSTEM 1660 SOUTH COLUMBIAN WAY SEATTLE WA 98108 KING 2067621010 501301 GARFIELD COUNTY MEMORIAL HOSPITAL 66 NORTH SIXTH STREET POMEROY WA 99347 GARFIELD 5098431591 501302 DAYTON GENERAL HOSPITAL 1012 SOUTH 3RD STREET DAYTON WA 99328 COLUMBIA 5093822531
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 225 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 501303 WILLAPA HARBOR HOSPITAL 800 ALDER STREET SOUTH BEND WA 98586 PACIFIC 3608755526 501304 SUMMIT PACIFIC MEDICAL CENTER‐SWING BED UNIT 600 EAST MAIN STREET ELMA WA 98541 GRAYS HARBOR 3603462222 501305 LINCOLN HOSPITAL 10 NICHOLS STREET DAVENPORT WA 99122 LINCOLN 5097257101 501307 ODESSA MEMORIAL HEALTHCARE CENTER 502 E AMENDE DRIVE ODESSA WA 99159 LINCOLN 5099822611 501308 COULEE COMMUNITY HOSPITAL 411 FORTUYN ROAD GRAND COULEE WA 99133 GRANT 5096331753 501309 PROVIDENCE ST JOSEPH HOSPITAL 500 EAST WEBSTER CHEWELAH WA 99109 STEVENS 5099358211 501310 NEWPORT COMMUNITY HOSPITAL 714 WEST PINE STREET NEWPORT WA 99156 PEND OREILLE 5094472441 501311 EAST ADAMS RURAL HOSPITAL 903 SOUTH ADAMS RITZVILLE WA 99169 ADAMS 5096591200 501312 PROSSER MEMORIAL HOSPITAL 723 MEMORIAL STREET PROSSER WA 99350 BENTON 5097862222 501313 CASCADE MEDICAL CENTER 817 COMMERCIAL STREET LEAVENWORTH WA 98826 CHELAN 5095485815 501314 OCEAN BEACH HOSPITAL 174 FIRST AVENUE NORTH ILWACO WA 98624 PACIFIC 3606423181 501315 SKYLINE HOSPITAL 211 SKYLINE DRIVE WHITE SALMON WA 98672 KLICKITAT 5094911101 501316 KLICKITAT VALLEY HOSPITAL 310 SOUTH ROOSEVELT GOLDENDALE WA 98620 KLICKITAT 5097734022 501317 COLUMBIA BASIN HOSPITAL 200 NAT WASHINGTON WAY EPHRATA WA 98823 GRANT 5097544631 501318 OTHELLO COMMUNITY HOSPITAL 315 NORTH 14TH AVENUE OTHELLO WA 99344 ADAMS 5094882636 501319 MORTON GENERAL HOSPITAL 521 ADAMS STREET MORTON WA 98356 LEWIS 3604965112 501320 QUINCY VALLEY HOSPITAL 908 10TH AVENUE SOUTHWEST QUINCY WA 98848 GRANT 5097873531 501321 NORTH VALLEY HOSPITAL 203 SOUTH WESTERN TONASKET WA 98855 OKANOGAN 5094862151 501322 FERRY COUNTY MEMORIAL HOSPITAL 36 KLONDIKE ROAD REPUBLIC WA 99166 FERRY 5097753333 501323 JEFFERSON HEALTHCARE 834 SHERIDAN STREET PORT TOWNSEND WA 98368 JEFFERSON 3603852200 501324 THREE RIVERS HOSPITAL 507 HOSPITAL WAY BREWSTER WA 98812 OKANOGAN 5096892517 501325 FORKS COMMUNITY HOSPITAL 530 BOGACHIEL WAY FORKS WA 98331 CLALLAM 3603746271 501326 PROVIDENCE MOUNT CARMEL HOSPITAL 982 EAST COLUMBIA COLVILLE WA 99114 STEVENS 5096842561 501327 WHITMAN HOSPITAL AND MEDICAL CENTER 1200 WEST FAIRVIEW COLFAX WA 99111 WHITMAN 5093973435 501328 MID VALLEY HOSPITAL 810 JASMINE STREET OMAK WA 98841 OKANOGAN 5098261760 501329 PEACEHEALTH UNITED GENERAL MEDICAL CENTER 2000 HOSPITAL DRIVE SEDRO WOOLLEY WA 98284 SKAGIT 3608566021 501330 SUNNYSIDE COMMUNITY HOSPITAL 1016 TACOMA AVENUE SUNNYSIDE WA 98944 YAKIMA 5098371500 501331 PULLMAN REGIONAL HOSPITAL 835 S BISHOP BLVD PULLMAN WA 99163 WHITMAN 5093322541 501332 TRI‐STATE MEMORIAL HOSPITAL 1221 HIGHLAND AVENUE CLARKSTON WA 99403 ASOTIN 5097585511 501333 KITTITAS VALLEY COMMUNITY HOSPITAL 603 SOUTH CHESTNUT ELLENSBURG WA 98926 KITTITAS 5099629841
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 226 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 501334 LAKE CHELAN COMMUNITY HOSPITAL 503 EAST HIGHLAND CHELAN WA 98816 CHELAN 5096823300 501335 ST ELIZABETH HOSPITAL 1450 BATTERSBY AVENUE ENUMCLAW WA 98022 KING 3608252505 501336 MASON GENERAL HOSPITAL & FAMILY OF CLINICS 901 MT VIEW DRIVE SHELTON WA 98584 MASON 3604261611 501337 LOURDES MEDICAL CENTER 520 N FOURTH AVENUE PASCO WA 99301 FRANKLIN 5095462278 501338 SNOQUALMIE VALLEY HOSPITAL 9801 FRONTIER AVE SE SNOQUALMIE WA 98065 KING 4258312300 501339 WHIDBEY GENERAL HOSPITAL 101 NORTH MAIN STREET COUPEVILLE WA 98239 ISLAND 3606785151 501340 PEACEHEALTH PEACE ISLAND MEDICAL CENTER 1117 SPRING STREET FRIDAY HARBOR WA 98250 SAN JUAN 3603782141 501992 SUNRISE HAVEN PO BOX 6057 24423 100TH AVENUE SOUTH KENT WA 98064 KING 2538132096 502001 REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX 16251 SYLVESTER SW ROAD BURIEN WA 98166 KING 2062484548 CARE 502002 KINDRED HOSPITAL‐SEATTLE 10631 8TH AVE NE SEATTLE WA 98125 KING 2063642050 503025 ST LUKES REHABILITATION INSTITUTE 711 SOUTH COWLEY ST SPOKANE WA 99202 SPOKANE 5094736000 503300 SEATTLE CHILDREN'S HOSPITAL 4800 SAND POINT WAY NE, PO BOX C‐5371 SEATTLE WA 98105 KING 2069872000 503301 MARY BRIDGE CHILDREN'S HOSPITAL 317 MARTIN LUTHER KING JR W BOX 5299 TACOMA WA 98415 PIERCE 2534031400 503302 SHRINERS HOSPITAL FOR CHILDREN 911 WEST 5TH AVENUE SPOKANE WA 99204 SPOKANE 5096230422 504002 BHC FAIRFAX HOSPITAL 10200 NE 132ND STREET KIRKLAND WA 98034 KING 4258212000 504003 WESTERN STATE HOSPITAL 9601 STEILACOOM BLVD SW TACOMA WA 98498 PIERCE 2537562350 504004 EASTERN STATE HOSPITAL 850 MAPLE STREET ‐ P O BOX AMEDICAL LAKE WA 99022 SPOKANE 5095654000 504008 LOURDES COUNSELING CENTER 1175 CARONDELET DRIVE RICHLAND WA 99352 BENTON 5099439104 504009 NAVOS 2600 SOUTHWEST HOLDEN SEATTLE WA 98126 KING 2069337299 504011 CASCADE BEHAVIORAL HOSPITAL 12844 MILITARY ROAD SOUTH TUKWILA WA 98168 KING 2062440180 509800 VIRGINIA MASON MEDICAL CENTER 1100 9TH AVE, MAILSTOP C1‐TX SEATTLE WA 98111 KING 2065836544 509801 SWEDISH MEDICAL CENTER TRANSPLANT SERVICES 1101 MADISON ST, SUITE 200 SEATTLE WA 98104 KING 2062153005 509802 UNIVERSITY OF WASHINGTON MEDICAL CENTER 1959 NE PACIFIC STREET SEATTLE WA 98195 KING 2065986364 509803 SEATTLE CHILDRENS HOSPITAL ‐ TRANSPLANT 4800 SAND POINT WAY NE (MAIL STOP MB9‐420) SEATTLE WA 98105 KING 2069875090 509804 PROVIDENCE SACRED HEART MEDICAL CENTER 101 W EIGHTH AVENUE SPOKANE WA 99204 SPOKANE 5094744500 510001 WEST VIRGINIA UNIVERSITY HOSPITALS MEDICAL CENTER DRIVE MORGANTOWN WV 26506 MONONGALIA 3045984000 510002 GREENBRIER VALLEY MEDICAL CENTER 1320 MAPLEWOOD AVENUE RONCEVERTE WV 24970 GREENBRIER 3046474411 510006 UNITED HOSPITAL CENTER 327 MEDICAL PARK DRIVE BRIDGEPORT WV 26330 HARRISON 6813421000 510007 ST MARY'S MEDICAL CENTER 2900 1ST AVENUE HUNTINGTON WV 25702 CABELL 3045261234
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 227 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 510008 BERKELEY MEDICAL CENTER 2500 HOSPITAL DRIVE MARTINSBURG WV 25401 BERKELEY 3042641000 510012 PLEASANT VALLEY HOSPITAL 2520 VALLEY DRIVE POINT PLEASANT WV 25550 MASON 3046754340 510013 REYNOLDS MEMORIAL HOSPITAL 800 WHEELING AVE GLEN DALE WV 26038 MARSHALL 3048433230 51001F FEDERAL REFORMATORY FOR WOMEN HOSP ALDERSON WV 24910 GREENBRIER 510022 CHARLESTON AREA MEDICAL CENTER 501 MORRIS STREET CHARLESTON WV 25301 KANAWHA 3043885432 510023 WEIRTON MEDICAL CENTER 601 COLLIERS WAY WEIRTON WV 26062 HANCOCK 3047976000 510024 MONONGALIA COUNTY GENERAL HOSPITAL 1200 JD ANDERSON DR MORGANTOWN WV 26505 MONONGALIA 3045981200 510029 THOMAS MEMORIAL HOSPITAL 4605 MACCORKLE AVE SW SOUTH CHARLESTON WV 25309 KANAWHA 3047663600 51002F BECKLEY VA MEDICAL CENTER 200 VETERANS AVE BECKLEY WV 25801 RALEIGH 3042552121 510030 DAVIS MEDICAL CENTER 812 GORMAN AVENUE ELKINS WV 26241 RANDOLPH 3046363300 510031 ST FRANCIS HOSPITAL 333 LAIDLEY ST CHARLESTON WV 25301 KANAWHA 3043476500 510038 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 LEWIS 3042698080 510039 OHIO VALLEY MEDICAL CENTER 2000 EOFF STREET WHEELING WV 26003 OHIO 3042340123 51003F LOUIS A JOHNSON VA MEDICAL CENTER (CLARKSBURG) ONE MEDICAL CENTER DRIVE CLARKSBURG WV 26301 HARRISON 3046233461
510046 PRINCETON COMMUNITY HOSPITAL 122 12TH STREET PRINCETON WV 24740 MERCER 3044877260 510047 FAIRMONT REGIONAL MEDICAL CENTER 1325 LOCUST AVENUE FAIRMONT WV 26554 MARION 3043677100 510048 LOGAN REGIONAL MEDICAL CENTER 20 HOSPITAL DRIVE LOGAN WV 25601 LOGAN 3048311350 51004F HUNTINGTON VA MEDICAL CENTER 1540 SPRING VALLEY DR HUNTINGTON WV 25704 CABELL 3044296741 510050 WHEELING HOSPITAL 1 MEDICAL PARK WHEELING WV 26003 OHIO 3042433000 510055 CABELL HUNTINGTON HOSPITAL INC 1340 HAL GREER BOULEVARD HUNTINGTON WV 25701 CABELL 3045262000 510058 CAMDEN CLARK MEDICAL CENTER 800 GARFIELD AVE PARKERSBURG WV 26101 WOOD 3044242111 51005F MARTINSBURG VA MEDICAL CENTER ROUTE 9 CHARLES TOWN ROAD MARTINSBURG WV 25401 BERKELEY 3042630811 510062 BECKLEY ARH HOSPITAL 306 STANAFORD ROAD BECKLEY WV 25801 RALEIGH 3042553456 510070 RALEIGH GENERAL HOSPITAL 1710 HARPER ROAD BECKLEY WV 25801 RALEIGH 3042564100 510071 BLUEFIELD REGIONAL MEDICAL CENTER 500 CHERRY ST BLUEFIELD WV 24701 MERCER 3043271100 510072 WETZEL COUNTY HOSPITAL #3 EAST BENJAMIN DRIVE NEW MARTINSVILLE WV 26155 WETZEL 3044558000 510077 WILLIAMSON MEMORIAL HOSPITAL 859 ALDERSON STREET WILLIAMSON WV 25661 MINGO 3042352500 510082 SUMMERSVILLE REGIONAL MEDICAL CENTER 400 FAIRVIEW HEIGHTS ROAD SUMMERSVILLE WV 26651 NICHOLAS 3048722891 510086 WELCH COMMUNITY HOSPITAL 454 MCDOWELL STREET WELCH WV 24801 MCDOWELL 3044368461
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 228 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 510091 CHARLESTON SURGICAL HOSPITAL 1306 KANAWHA BOULEVARD EAST CHARLESTON WV 25301 KANAWHA 3043434371 511300 BROADDUS HOSPITAL ASSOCIATION, INC MANSFIELD HILL PHILIPPI WV 26416 BARBOUR 3044571760 511301 WEBSTER COUNTY MEMORIAL HOSPITAL 324 MILLER MOUNTAIN DRIVE WEBSTER SPRINGS WV 26288 WEBSTER 3048475682 511303 MINNIE HAMILTON HEALTH CARE CENTER 186 HOSPITAL DRIVE GRANTSVILLE WV 26147 CALHOUN 3043549244 511304 SISTERSVILLE GENERAL HOSPITAL 314 SOUTH WELLS STREET SISTERSVILLE WV 26175 TYLER 3046522611 511306 ROANE GENERAL HOSPITAL 200 HOSPITAL DRIVE SPENCER WV 25276 ROANE 3049274444 511307 GRAFTON CITY HOSPITAL 1 HOSPITAL PLAZA GRAFTON WV 26354 TAYLOR 3042650400 511308 BRAXTON COUNTY MEMORIAL HOSPITAL 100 HOYLMAN DRIVE GASSAWAY WV 26624 BRAXTON 3043645156 511309 WAR MEMORIAL HOSPITAL INC 1 HEALTHY WAY BERKELEY SPRINGS WV 25411 MORGAN 3042581234 511310 SUMMERS COUNTY ARH HOSPITAL 115 SUMMERS HOSPITAL ROAD HINTON WV 25951 SUMMERS 3044661000 511311 HAMPSHIRE MEMORIAL HOSPITAL 363 SUNRISE BOULEVARD ROMNEY WV 26757 HAMPSHIRE 3048224561 511312 PRESTON MEMORIAL HOSPITAL 150 MEMORIAL DRIVE KINGWOOD WV 26537 PRESTON 3043291400 511313 BOONE MEMORIAL HOSPITAL 701 MADISON AVENUE MADISON WV 25130 BOONE 3043691230 511314 POCAHONTAS MEMORIAL HOSPITAL 150 DUNCAN ROAD BUCKEYE WV 24924 POCAHONTAS 3047997400 511315 POTOMAC VALLEY HOSPITAL 100 PIN OAK LANE KEYSER WV 26726 MINERAL 3045973500 511316 GRANT MEMORIAL HOSPITAL 117 HOSPITAL DRIVE PETERSBURG WV 26847 GRANT 3042571026 511317 PLATEAU MEDICAL CENTER 430 MAIN STREET, WEST OAK HILL WV 25901 FAYETTE 3044698600 511318 MONTGOMERY GENERAL HOSPITAL, INC 401 SIXTH AVENUE MONTGOMERY WV 25136 FAYETTE 3044425151 511319 JEFFERSON MEDICAL CENTER 300 SOUTH PRESTON STREET RANSON WV 25438 JEFFERSON 3047281600 511320 JACKSON GENERAL HOSPITAL 122 PINNELL ST RIPLEY WV 25271 JACKSON 3043722731 511321 ST JOSEPH HOSPITAL 1 AMALIA DRIVE BUCKHANNON WV 26201 UPSHUR 3044722000 512002 SELECT SPECIALTY HOSPITAL 333 LAIDLEY STREET CHARLESTON WV 25301 KANAWHA 3043886671 512003 CORNERSTONE HOSPITAL OF HUNTINGTON 2900 FIRST AVENUE, 2E HUNTINGTON WV 25702 CABELL 3043992600 513025 PETERSON HEALTHCARE AND REHABILITATION HOSPITAL HOMESTEAD AVENUE WHEELING WV 26003 OHIO 3042340500
513026 HEALTHSOUTH SOUTHERN HILLS REHABILITATION 120 12TH ST PRINCETON WV 24740 MERCER 3044878000 HOSPITAL 513027 HEALTHSOUTH WESTERN HILLS REGIONAL REHAB #3 WESTERN HILLS DRIVE PARKERSBURG WV 26105 WOOD 3044201300 HOSPITAL 513028 HEALTHSOUTH REHABILITATION HOSPITAL OF 6900 WEST COUNTRY CLUB DRIVE HUNTINGTON WV 25705 CABELL 3047331060 HUNTINGTON
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 229 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 513030 HEALTHSOUTH MOUNTAINVIEW REGIONAL REHAB 1160 VAN VOORHIS ROAD MORGANTOWN WV 26504 MONONGALIA 3045981100 HOSPITAL 514001 HIGHLAND HOSPITAL 1418A MACCORKLE AVENUE SW CHARLESTON WV 25303 KANAWHA 3049261600 514008 RIVER PARK HOSPITAL 1230 SIXTH AVENUE HUNTINGTON WV 25701 CABELL 3045269100 514009 MILDRED MITCHELL‐BATEMAN HOSPITAL 1530 NORWAY AVENUE HUNTINGTON WV 25709 WAYNE 3045257801 514010 WILLIAM R SHARPE, JR HOSPITAL 936 SHARPE HOSPITAL ROAD WESTON WV 26452 LEWIS 3042691210 514011 HIGHLAND‐CLARKSBURG HOSPITAL INC 3 HOSPITAL PLAZA CLARKSBURG WV 26301 HARRISON 3046224951 519800 CHARLESTON AREA MEDICAL CENTER ‐ TRANSPLANT PO BOX 1393, 501 MORRIS ST CHARLESTON WV 25325 KANAWHA 3043886525 520002 MINISTRY ST MICHAELS HOSPITAL OF STEVENS POINT 900 ILLINOIS AVE STEVENS POINT WI 54481 PORTAGE 7153465000 520004 MAYO CLINIC HLTH SYSTEM FRANCISCAN MED CTR 700 WEST AVENUE SOUTH LA CROSSE WI 54601 LA CROSSE 6087850940 520008 WAUKESHA MEMORIAL HOSPITAL 725 AMERICAN AVE WAUKESHA WI 53188 WAUKESHA 2629281000 520009 ST ELIZABETH HOSPITAL 1506 S ONEIDA ST APPLETON WI 54915 OUTAGAMIE 9207382000 520011 LAKEVIEW MEDICAL CENTER 1700 WEST STOUT STREET RICE LAKE WI 54868 BARRON 7152341515 520013 SACRED HEART HOSPITAL 900 W CLAIREMONT AVE EAU CLAIRE WI 54701 EAU CLAIRE 7157174121 520017 ST JOSEPHS HOSPITAL 2661 COUNTY HWY I CHIPPEWA FALLS WI 54729 CHIPPEWA 7157177200 520019 MINISTRY SAINT MARYS HOSPITAL 2251 NORTH SHORE DR RHINELANDER WI 54501 ONEIDA 7153612000 520021 UNITED HOSPITAL SYSTEM 6308 EIGHTH AVE KENOSHA WI 53143 KENOSHA 2626562011 520027 COLUMBIA ST MARYS HOSPITAL OZAUKEE 13111 N PORT WASHINGTON RD MEQUON WI 53097 OZAUKEE 2622437300 520028 THE MONROE CLINIC 2005 5TH STREET MONROE WI 53566 GREEN 6083241000 52002F TOMAH VA MEDICAL CENTER 500 EAST VETERANS STREET TOMAH WI 54660 MONROE 6083723971 520030 ASPIRUS WAUSAU HOSPITAL 333 PINE RIDGE BLVD WAUSAU WI 54401 MARATHON 7158472121 520033 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY ST WISCONSIN RAPIDS WI 54495 WOOD 7154236060 520034 AURORA MEDICAL CTR MANITOWOC COUNTY 5000 MEMORIAL DRIVE TWO RIVERS WI 54241 MANITOWOC 9207945000 520035 AURORA SHEBOYGAN MEMORIAL MEDICAL CTR 2629 N 7TH ST SHEBOYGAN WI 53083 SHEBOYGAN 9204515000 520037 MINISTRY SAINT JOSEPHS HOSPITAL 611 ST JOSEPH AVE MARSHFIELD WI 54449 WOOD 7153877850 520038 AURORA MEDICAL CTR WASHINGTON COUNTY 1032 E SUMNER ST HARTFORD WI 53027 WASHINGTON 2626732300 52003F CLEMENT J ZABLOCKI VETERANS AFFAIRS 5000 WEST NATIONAL AVENUE MILWAUKEE WI 53295 MILWAUKEE 4143842000 520041 DIVINE SAVIOR HEALTHCARE 2817 NEW PINERY ROAD PORTAGE WI 53901 COLUMBIA 6087424131 520044 ST NICHOLAS HOSPITAL 3100 SUPERIOR AVE SHEBOYGAN WI 53081 SHEBOYGAN 9204598300 520045 THEDACARE REGIONAL MEDICAL CENTER ‐ NEENAH INC 130 2ND ST NEENAH WI 54956 WINNEBAGO 9207293100
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 230 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 520048 MERCY MEDICAL CENTER OF OSHKOSH 500 S OAKWOOD RD OSHKOSH WI 54904 WINNEBAGO 9202232000 520049 BELLIN MEMORIAL HOSPITAL 744 S WEBSTER AVE GREEN BAY WI 54305 BROWN 9204333500 52004F WILLIAM S MIDDLETON MEMORIAL VETERANS HOSPITAL 2500 OVERLOOK TERRACE MADISON WI 53705 DANE 6082561901
520051 COLUMBIA ST MARYS HOSPITAL MILWAUKEE 2323 N LAKE DR MILWAUKEE WI 53211 MILWAUKEE 4142911000 520057 ST CLARE HOSPITAL 707 14TH ST BARABOO WI 53913 SAUK 6083561400 520059 AURORA MEMORIAL HOSPITAL BURLINGTON 252 MCHENRY ST BURLINGTON WI 53105 RACINE 2627676545 520062 OCONOMOWOC MEMORIAL HOSPITAL 791 E SUMMIT AVE OCONOMOWOC WI 53066 WAUKESHA 2625699400 520063 ST JOSEPHS COMMUNITY HOSPITAL OF WEST BEND 3200 PLEASANT VALLEY ROAD WEST BEND WI 53095 WASHINGTON 2623345533 520066 MERCY HEALTH SYSTEM CORP 1000 MINERAL POINT AVE JANESVILLE WI 53548 ROCK 6087566080 520070 MAYO CLINIC HEALTH SYSTEM EAU CLAIRE HOSPITAL 1221 WHIPPLE ST EAU CLAIRE WI 54703 EAU CLAIRE 7158383311 520071 FORT MEMORIAL HOSPITAL 611 SHERMAN AVE EFORT ATKINSON WI 53538 JEFFERSON 9205685000 520075 ST VINCENT HOSPITAL 835 S VAN BUREN ST GREEN BAY WI 54301 BROWN 9204330111 520076 BEAVER DAM COMMUNITY HOSPITAL 707 S UNIVERSITY AVE BEAVER DAM WI 53916 DODGE 9208877181 520078 WHEATON FRANCISCAN HEALTHCARE ST FRANCIS 3237 S 16TH ST MILWAUKEE WI 53215 MILWAUKEE 4146475000 520083 ST MARYS HOSPITAL 700 SOUTH PARK ST MADISON WI 53715 DANE 6082516100 520087 GUNDERSEN LUTHERAN MEDICAL CENTER 1910 SOUTH AVE LA CROSSE WI 54601 LA CROSSE 6087827300 520088 ST AGNES HOSPITAL 430 E DIVISON ST FOND DU LAC WI 54935 FOND DU LAC 9209292300 520089 UNITYPOINT HEALTH ‐ MERITER 202 S PARK ST MADISON WI 53715 DANE 6084176000 520091 HOWARD YOUNG MEDICAL CTR 240 MAPLE ST WOODRUFF WI 54568 ONEIDA 7153568000 520095 SAUK PRAIRIE HOSPITAL 260 26TH STREET PRAIRIE DU SAC WI 53578 SAUK 6086433311 520096 WHEATON FRANCISCAN HEALTHCARE ALL SAINTS 3801 SPRING ST RACINE WI 53405 RACINE 2626874011 520097 ST MARYS HOSPITAL MEDICAL CTR 1726 SHAWANO AVE GREEN BAY WI 54303 BROWN 9204984200 520098 UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY 600 HIGHLAND AVENUE MADISON WI 53792 DANE 6082638991 520100 BELOIT MEMORIAL HOSPITAL 1969 W HART RD BELOIT WI 53511 ROCK 6083645011 520102 AURORA LAKELAND MEDICAL CENTER W3985 COUNTY ROAD NN ELKHORN WI 53121 WALWORTH 2627412000 520103 COMMUNITY MEMORIAL HOSPITAL W180 N8085 TOWN HALL RD MENOMONEE FALLS WI 53051 WAUKESHA 2622511000 520107 HOLY FAMILY MEMORIAL 2300 WESTERN AVE MANITOWOC WI 54221 MANITOWOC 9203202011 520109 MILE BLUFF MEDICAL CENTER 1050 DIVISION ST MAUSTON WI 53948 JUNEAU 6088476161 520113 BAY AREA MEDICAL CENTER 3100 SHORE DRIVE MARINETTE WI 54143 MARINETTE 7157356621
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 231 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 520116 WATERTOWN REGIONAL MEDICAL CENTER 125 HOSPITAL DRIVE WATERTOWN WI 53098 DODGE 9202614210 520136 WHEATON FRANCISCAN ST JOSEPH 5000 W CHAMBERS ST MILWAUKEE WI 53210 MILWAUKEE 4144472000 520138 AURORA ST LUKES MEDICAL CENTER 2900 W OKLAHOMA AVE MILWAUKEE WI 53215 MILWAUKEE 4146496000 520139 AURORA WEST ALLIS MEDICAL CENTER 8901 W LINCOLN AVE WEST ALLIS WI 53227 MILWAUKEE 4143286000 520160 THEDACARE REGIONAL MEDICAL CENTER ‐ APPLETON INC 1818 N MEADE ST APPLETON WI 54911 OUTAGAMIE 9207314101
520177 FROEDTERT MEMORIAL LUTHERAN HOSPITAL 9200 W WISCONSIN AVE MILWAUKEE WI 53226 MILWAUKEE 4148053000 520189 AURORA MEDICAL CTR KENOSHA 10400 75TH ST KENOSHA WI 53142 KENOSHA 2629485600 520193 AURORA BAYCARE MEDICAL CTR 2845 GREENBRIER RD GREEN BAY WI 54311 BROWN 9202888000 520194 ORTHOPAEDIC HOSPITAL OF WISCONSIN 475 W RIVER WOODS PKWY GLENDALE WI 53212 MILWAUKEE 4149616800 520195 COLUMBIA CENTER 13125 N PORT WASHINGTON RD MEQUON WI 53097 OZAUKEE 2622437408 520196 OAKLEAF SURGICAL HOSPITAL 1000 OAKLEAF WAY ALTOONA WI 54720 EAU CLAIRE 7158318130 520198 AURORA MEDICAL CTR OSHKOSH 855 N WESTHAVEN DRIVE OSHKOSH WI 54904 WINNEBAGO 9204566000 520202 ST CLARES HOSPITAL OF WESTON 3400 MINISTRY PARKWAY WESTON WI 54476 MARATHON 7153933000 520204 WHEATON FRANCISCAN HEALTHCARE FRANKLIN 10101 SOUTH 27TH ST FRANKLIN WI 53132 MILWAUKEE 4143254500 520205 MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL 10101 SOUTH 27TH ST 2ND FLOOR FRANKLIN WI 53132 MILWAUKEE 4148175800 520206 AURORA MEDICAL CENTER 36500 AURORA DRIVE SUMMIT WI 53066 WAUKESHA 2624341000 520207 AURORA MEDICAL CENTER 975 PORT WASHINGTON ROAD GRAFTON WI 53024 OZAUKEE 2623291000 520208 ST MARYS JANESVILLE HOSPITAL 3400 EAST RACINE STREET JANESVILLE WI 53546 ROCK 6083738000 521300 MINISTRY EAGLE RIVER MEMORIAL HOSPITAL 201 HOSPITAL ROAD EAGLE RIVER WI 54521 VILAS 7154797411 521302 MAYO CLINIC HEALTH SYSTEM OAKRIDGE 13025 8TH ST OSSEO WI 54758 TREMPEALEAU 7155973121 521303 THEDACARE MEDICAL CENTER ‐ WILD ROSE INC 601 GROVE AVE WILD ROSE WI 54984 WAUSHARA 9206223257 521304 ST JOSEPHS HEALTH SERVICES 400 WATER AVE HILLSBORO WI 54634 VERNON 6084898000 521305 MAYO CLINIC HLTH SYSTM FRANCISCAN HLTHCARE SPARTA 310 W MAIN ST SPARTA WI 54656 MONROE 6082692132
521307 CHIPPEWA VALLEY HOSPITAL 1220 3RD AVE W DURAND WI 54736 PEPIN 7156724211 521308 AMERY HOSPITAL & CLINIC 265 GRIFFIN STREET EAST AMERY WI 54001 POLK 7152680300 521309 MOUNDVIEW MEMORIAL HOSPITAL AND CLINICS 402 W LAKE ST FRIENDSHIP WI 53934 ADAMS 6083393331 521310 HSHS ST CLARE MEMORIAL HOSPITAL 855 S MAIN ST OCONTO FALLS WI 54154 OCONTO 9208463444 521311 OUR LADY OF VICTORY HOSPITAL 1120 PINE ST STANLEY WI 54768 CHIPPEWA 7156445571 521312 MEMORIAL HOSPITAL OF LAFAYETTE COUNTY 800 CLAY ST DARLINGTON WI 53530 LAFAYETTE 6087764466
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 232 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 521313 MINISTRY SACRED HEART HOSPITAL 401 W MOHAWK DR SUITE 100 TOMAHAWK WI 54487 LINCOLN 7154537700 521314 MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY 1501 THOMPSON ST BLOOMER WI 54724 CHIPPEWA 7155682000 521315 MAYO CLINIC HEALTH SYSTEM NORTHLAND 1222 E WOODLAND AVE BARRON WI 54812 BARRON 7155373186 521316 TRI COUNTY MEMORIAL HOSPITAL 18601 LINCOLN ST WHITEHALL WI 54773 TREMPEALEAU 7155384361 521317 CALUMET MEDICAL CENTER 614 MEMORIAL DRIVE CHILTON WI 53014 CALUMET 9208492386 521318 LADD MEMORIAL HOSPITAL 2600 65TH AVENUE OSCEOLA WI 54020 POLK 7152942111 521319 EDGERTON HOSPITAL AND HEALTH SERVICES 11101 N SHERMAN ROAD EDGERTON WI 53534 ROCK 6088843441 521320 TOMAH MEMORIAL HOSPITAL 321 BUTTS AVE TOMAH WI 54660 MONROE 6083722181 521321 RIPON MEDICAL CENTER 845 PARKSIDE ST RIPON WI 54971 FOND DU LAC 9207483101 521322 GRANT REGIONAL HEALTH CENTER 507 S MONROE ST LANCASTER WI 53813 GRANT 6087232143 521323 MEMORIAL MEDICAL CENTER 216 SUNSET PLACE NEILLSVILLE WI 54456 CLARK 7157433101 521324 ASPIRUS MEDFORD HOSPITAL & CLINICS, INC 135 S GIBSON ST MEDFORD WI 54451 TAYLOR 7157488100 521325 FLAMBEAU HOSPITAL 98 SHERRY AVE PARK FALLS WI 54552 PRICE 7157627500 521326 THEDACARE MEDICAL CENTER NEW LONDON 1405 MILL ST NEW LONDON WI 54961 OUTAGAMIE 9205312000 521327 WAUPUN MEMORIAL HOSPITAL 620 W BROWN ST WAUPUN WI 53963 DODGE 9203246530 521328 RUSK COUNTY MEMORIAL HOSPITAL 900 COLLEGE AVE WEST LADYSMITH WI 54848 RUSK 7155325561 521329 ST MARYS HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 DOUGLAS 7158177000 521330 CROSSING RIVERS HEALTH MEDICAL CENTER 37868 US HWY 18 PRAIRIE DU CHIEN WI 53821 CRAWFORD 6083572000 521331 BURNETT MEDICAL CENTER 257 W ST GEORGE AVE GRANTSBURG WI 54840 BURNETT 7154635353 521332 SPOONER HEALTH SYSTEM 1280 CHANDLER DR SPOONER WI 54801 WASHBURN 7156352111 521333 BLACK RIVER MEMORIAL HOSPITAL 711 W ADAMS ST BLACK RIVER FALLS WI 54615 JACKSON 7152845361 521334 THEDACARE MEDICAL CENTER ‐ WAUPACA INC 800 RIVERSIDE DRIVE WAUPACA WI 54981 WAUPACA 7152581000 521335 HUDSON HOSPITAL 405 STAGELINE ROAD HUDSON WI 54016 ST. CROIX 7155316000 521336 HAYWARD AREA MEMORIAL HOSPITAL 11040 N STATE RD 77 HAYWARD WI 54843 SAWYER 7159344321 521337 ST CROIX REGIONAL MEDICAL CENTER 235 STATE STREET SAINT CROIX FALLS WI 54024 POLK 7154833261 521338 COLUMBUS COMMUNITY HOSPITAL 1515 PARK AVE COLUMBUS WI 53925 COLUMBIA 9206232200 521339 GOOD SAMARITAN HEALTH CENTER 601 S CENTER AVE MERRILL WI 54452 LINCOLN 7155365511 521340 MAYO CLINIC HEALTH SYSTEM RED CEDAR 2321 STOUT RD MENOMONIE WI 54751 DUNN 7152355531 521341 RICHLAND HOSPITAL 333 E SECOND ST RICHLAND CENTER WI 53581 RICHLAND 6086476321 521342 INDIANHEAD MEDICAL CTR 113 4TH AVE SHELL LAKE WI 54871 WASHBURN 7154687833
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 233 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 521343 STOUGHTON HOSPITAL 900 RIDGE ST STOUGHTON WI 53589 DANE 6088736611 521344 GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS 205 PARKER ST BOSCOBEL WI 53805 GRANT 6083754112
521345 WESTFIELDS HOSPITAL AND CLINIC 535 HOSPITAL RD NEW RICHMOND WI 54017 ST. CROIX 7152432600 521346 THEDACARE MEDICAL CENTER ‐ SHAWANO INC 100 COUNTY RD B SHAWANO WI 54166 SHAWANO 7155262111 521347 BALDWIN AREA MEDICAL CENTER 730 10TH AVE BALDWIN WI 54002 ST. CROIX 7156843311 521348 VERNON MEMORIAL HOSPITAL 507 SOUTH MAIN ST VIROQUA WI 54665 VERNON 6086372101 521349 RIVER FALLS AREA HOSPITAL 1629 E DIVISION ST RIVER FALLS WI 54022 PIERCE 7153076000 521350 ASPIRUS LANGLADE HOSPITAL 112 E FIFTH AVE ANTIGO WI 54409 LANGLADE 7156232331 521351 REEDSBURG AREA MEDICAL CENTER 2000 N DEWEY AVE REEDSBURG WI 53959 SAUK 6085246487 521352 UPLAND HILLS HEALTH 800 COMPASSION WAY DODGEVILLE WI 53533 IOWA 6089308000 521353 CUMBERLAND MEMORIAL HOSPITAL 1110 7TH AVENUE CUMBERLAND WI 54829 BARRON 7158222741 521354 SOUTHWEST HEALTH CENTER 1400 EAST SIDE RD PLATTEVILLE WI 53818 GRANT 6083482331 521355 THEDACARE MEDICAL CENTER ‐ BERLIN INC 225 MEMORIAL DRIVE BERLIN WI 54923 GREEN LAKE 9203611313 521356 BELLIN HEALTH OCONTO HOSPITAL 820 ARBUTUS AVE OCONTO WI 54153 OCONTO 9208351101 521357 MERCY WALWORTH HOSPITAL & MEDICAL CENTER N2950 STATE ROAD 67 LAKE GENEVA WI 53147 WALWORTH 2622450535 521358 MINISTRY DOOR COUNTY MEDICAL CENTER 323 SOUTH 18TH AVENUE STURGEON BAY WI 54235 DOOR 9207435566 521359 MEMORIAL MEDICAL CENTER 1615 MAPLE LANE ASHLAND WI 54806 ASHLAND 7156855500 521990 CLEARVIEW HOME CORPORATION 935 MAIN ST DELAFIELD WI 53018 WAUKESHA 2626463361 522004 PAM SPECIALTY HOSPITAL OF MILWAUKEE 5017 S 110TH ST GREENFIELD WI 53228 MILWAUKEE 4144278282 522005 LAKEVIEW SPECIALTY HOSPITAL & REHAB CENTER 1701 SHARP ROAD WATERFORD WI 53185 RACINE 2625347297 522006 SELECT SPECIALTY HOSPITAL MILWAUKEE 8901 W LINCOLN AVE 2ND FLOOR WEST ALLIS WI 53227 MILWAUKEE 4143287700 522007 LIFECARE HOSPITALS OF WISCONSIN 2400 GOLF ROAD PEWAUKEE WI 53072 WAUKESHA 2625242600 522008 SELECT SPECIALTY HOSPITAL MADISON 801 BRAXTON PLACE MADISON WI 53715 DANE 6082602700 523025 SACRED HEART REHABILITATION INSTITUTE 2301 N LAKE DRIVE 8TH FLOOR MILWAUKEE WI 53211 MILWAUKEE 4145856700 523027 REHABILITATION HOSPITAL OF WISCONSIN 1625 COLD WATER CREEK DRIVE WAUKESHA WI 53188 WAUKESHA 2625218800 523028 UW HEALTH REHABILITATION HOSPITAL 5115 N BILTMORE LN MADISON WI 53718 DANE 6085928173 523300 CHILDRENS HOSPITAL OF WISCONSIN 9000 W WISCONSIN AVE MILWAUKEE WI 53226 MILWAUKEE 4142662000 523302 CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY 130 SECOND ST NEENAH WI 54956 WINNEBAGO 9209697900 524000 AURORA PSYCHIATRIC HOSPITAL 1220 DEWEY AVE WAUWATOSA WI 53213 MILWAUKEE 4144546600
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 234 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 524001 MILWAUKEE COUNTY BEHAVIORAL HEALTH DIVISION 9455 W WATERTOWN PLANK RD MILWAUKEE WI 53226 MILWAUKEE 4142575202 524002 WINNEBAGO MENTAL HEALTH INSTITUTE 1300 SOUTH DRIVE WINNEBAGO WI 54985 WINNEBAGO 9202354910 524008 MENDOTA MENTAL HEALTH INSTITUTE 301 TROY DR MADISON WI 53704 DANE 6083011000 524014 BROWN COUNTY COMMUNITY TREATMENT CTR 3150 GERSHWIN DRIVE GREEN BAY WI 54311 BROWN 9203914700 524017 NORTH CENTRAL HEALTH CARE 1100 LAKEVIEW DR WAUSAU WI 54403 MARATHON 7158484600 524018 ROGERS MEMORIAL HOSPITAL 34700 VALLEY RD OCONOMOWOC WI 53066 WAUKESHA 2626464411 524019 NORWOOD HEALTH CENTER 1600 N CHESTNUT AVE MARSHFIELD WI 54449 WOOD 7153842188 524025 FOND DU LAC COUNTY ACUTE PSYCH UNIT 459 E FIRST ST FOND DU LAC WI 54935 FOND DU LAC 9209293500 524026 WAUKESHA COUNTY MENTAL HEALTH CTR 1501 AIRPORT RD WAUKESHA WI 53188 WAUKESHA 2625487950 524038 BELLIN PSYCHIATRIC CENTER 301 E ST JOSEPH ST GREEN BAY WI 54301 BROWN 9204333630 529801 AURORA ST LUKES MEDICAL CENTER 2900 W OKLAHOMA AVE 5TH FLOOR GALLERIA BUILDING MILWAUKEE WI 53215 MILWAUKEE 4146461865
529802 UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS 600 HIGHLAND AVE MADISON WI 53792 DANE 6082657050 529803 CHILDRENS HOSPITAL OF WISCONSIN 9000 W WISCONSIN AVEUNE MILWAUKEE WI 53226 MILWAUKEE 4142662000 529804 FROEDTERT MEMORIAL LUTHERAN HOSPITAL 9200 W WISCONSIN AVE MILWAUKEE WI 53226 MILWAUKEE 4148050008 530002 CAMPBELL COUNTY MEMORIAL HOSPITAL 501 SOUTH BURMA AVENUE GILLETTE WY 82716 CAMPBELL 3076881551 530006 SHERIDAN MEMORIAL HOSPITAL 1401 W 5TH ST SHERIDAN WY 82801 SHERIDAN 3076721044 530008 SAGEWEST HEALTH CARE 2100 W SUNSET DR RIVERTON WY 82501 FREMONT 3078564161 530011 MEMORIAL HOSPITAL SWEETWATER COUNTY 1200 COLLEGE DRIVE ROCK SPRINGS WY 82901 SWEETWATER 3073623711 530012 WYOMING MEDICAL CENTER 1233 EAST 2ND ST CASPER WY 82601 NATRONA 3075777201 530014 CHEYENNE REGIONAL MEDICAL CENTER 214 EAST 23RD STREET CHEYENNE WY 82001 LARAMIE 3076342273 530015 ST JOHNS MEDICAL CENTER 625 EAST BROADWAY JACKSON WY 83001 TETON 3077333636 53001F US AIR FORCE HOSP FRANCIS E WARREN AFB CHEYENNE WY 82003 LARAMIE 530025 IVINSON MEMORIAL HOSPITAL 255 N 30TH LARAMIE WY 82072 ALBANY 3077422141 530032 EVANSTON REGIONAL HOSPITAL 190 ARROWHEAD DR EVANSTON WY 82930 UINTA 3077893636 530033 MOUNTAIN VIEW REGIONAL HOSPITAL 6550 EAST 2ND STREET CASPER WY 82605 NATRONA 3079958100 530034 SUMMIT MEDICAL CENTER 6350 E 2ND STREET CASPER WY 82609 NATRONA 3072326600 53004F VA HOSP 2360 E PERSHING BLVD CHEYENNE WY 82001 LARAMIE 53005F VA HOSP SHERIDAN WY 82801 SHERIDAN 53006E LAKE HOSP YELLOWSTONE NATL PARK WY 83020
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 235 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 53009E LAKE HOSP LAKE VILLAGE YELLOWSTONE NATIONAL PARK WY 83020 531301 SOUTH BIG HORN COUNTY CRITICAL ACCESS HOSPITAL 388 US HIGHWAY 20 SOUTH BASIN WY 82410 BIG HORN 3075683311
531302 MEMORIAL HOSPITAL OF CONVERSE COUNTY 111 SOUTH 5TH STREET DOUGLAS WY 82633 CONVERSE 3073582122 531303 WESTON COUNTY HEALTH SERVICES 1124 WASHINGTON BOULEVARD NEWCASTLE WY 82701 WESTON 3077464491 531304 HOT SPRINGS COUNTY MEMORIAL HOSPITAL 150 EAST ARAPAHOE THERMOPOLIS WY 82443 HOT SPRINGS 3078643121 531305 PLATTE COUNTY MEMORIAL HOSPITAL 201 14TH STREET WHEATLAND WY 82201 PLATTE 3073223636 531306 WASHAKIE MEDICAL CENTER 400 SOUTH 15TH STREET WORLAND WY 82401 WASHAKIE 3073473221 531307 COMMUNITY HOSPITAL 2000 CAMPBELL DRIVE TORRINGTON WY 82240 GOSHEN 3075324181 531308 JOHNSON COUNTY HEALTHCARE CENTER 497 WEST LOTT BUFFALO WY 82834 JOHNSON 3076845521 531309 NORTH BIG HORN HOSPITAL DISTRICT 1115 LANE 12 LOVELL WY 82431 BIG HORN 3075485200 531310 POWELL VALLEY HOSPITAL 777 AVENUE H POWELL WY 82435 PARK 3077542267 531311 CROOK COUNTY HOSPITAL 713 OAK STREET SUNDANCE WY 82729 CROOK 3072833501 531312 WEST PARK HOSPITAL DISTRICT 707 SHERIDAN AVENUE CODY WY 82414 PARK 3075782488 531313 STAR VALLEY MEDICAL CENTER 901 ADAMS STREET AFTON WY 83110 LINCOLN 3078855800 531314 NIOBRARA HEALTH & LIFE CENTER 921 SOUTH BALLANCEE AVENUE LUSK WY 82225 NIOBRARA 3073344000 531315 SOUTH LINCOLN MEDICAL CENTER ‐ CAH 711 ONYX STREET KEMMERER WY 83101 LINCOLN 3078774401 531316 MEMORIAL HOSPITAL OF CARBON COUNTY 2221 WEST ELM STREET RAWLINS WY 82301 CARBON 3073242221 533027 ELKHORN VALLEY REHABILITATION HOSPITAL LLC 5715 EAST 2ND STREET CASPER WY 82609 NATRONA 3072650005 534001 WYOMING STATE HOSPITAL 831 HWY 150 SOUTH EVANSTON WY 82931 UINTA 3077893464 534004 WYOMING BEHAVIORAL INSTITUTE 2521 EAST 15TH STREET CASPER WY 82609 NATRONA 3072377444 640001 LBJ TROPICAL MEDICAL CENTER FAGAALU VILLAGE PAGO PAGO AS 96799 6846334590 650001 GUAM MEMORIAL HOSPITAL AUTHORITY 85O GOV CARLOS G CAMACHO ROAD TAMUNING GU 96913 6716472552 650003 GUAM REGIONAL MEDICAL CITY 133 ROUTE 3 DEDEDO GU 96929 6716455500 65001F U S NAVAL HOSP MARIANA ISLANDS GU 96910 670004 ST MARKS MEDICAL CENTER ONE ST MARK'S PLACE LA GRANGE TX 78945 FAYETTE 9792422200 670005 MEMORIAL HERMANN SURGICAL HOSPITAL KINGWOOD 300 KINGWOOD MEDICAL DRIVE KINGWOOD TX 77339 HARRIS 2813124000
670006 THE HOSPITAL AT WESTLAKE MEDICAL CENTER 5656 BEE CAVES ROAD, SUITE M‐302 AUSTIN TX 78746 TRAVIS 5123270000 670008 HOUSTON PHYSICIANS' HOSPITAL 333 N TEXAS AVENUE WEBSTER TX 77598 HARRIS 2813351700 670010 MAYHILL HOSPITAL 2809 SOUTH MAYHILL ROAD DENTON TX 76208 DENTON 9402393000
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 236 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 670019 UNIVERSITY GENERAL HOSPITAL 7501 FANNIN HOUSTON TX 77054 HARRIS 7133757100 670023 METHODIST MANSFIELD MEDICAL CENTER 2700 E BROAD STREET MANSFIELD TX 76063 TARRANT 6826222059 670024 NORTH CYPRESS MEDICAL CENTER 21214 NORTHWEST FREEWAY CYPRESS TX 77429 HARRIS 2818900203 670025 THE HEART HOSPITAL BAYLOR PLANO 1100 ALLIED DRIVE PLANO TX 75093 COLLIN 4698143278 670027 ACUITY HOSPITAL OF HOUSTON 2001 HERMANN DRIVE HOUSTON TX 77004 HARRIS 7137950200 670031 ST LUKE'S PATIENTS MEDICAL CENTER 4600 EAST SAM HOUSTON PARKWAY SOUTH PASADENA TX 77505 HARRIS 2814870700 670034 SCOTT & WHITE HOSPITAL‐ROUND ROCK 300 UNIVERSITY BLVD ROUND ROCK TX 78664 WILLIAMSON 5125090100 670041 SETON MEDICAL CENTER WILLIAMSON 201 SETON PARKWAY ROUND ROCK TX 78664 WILLIAMSON 5123240000 670043 CEDAR PARK REGIONAL MEDICAL CENTER 1401 MEDICAL PARKWAY CEDAR PARK TX 78613 WILLIAMSON 5125287000 670044 TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL 3150 HORIZON ROAD ROCKWALL TX 75032 ROCKWALL 4696981000 670045 COOK CHILDRENS NORTHEAST HOSPITAL, LLC 6316 PRECINCT LINE RD HURST TX 76054 TARRANT 8176052500 670046 USMD HOSPITAL AT FORT WORTH LP 5900 ALTAMESA BLVD FORT WORTH TX 76132 TARRANT 8174339100 670047 SIERRA PROVIDENCE EAST MEDICAL CENTER 3280 JOE BATTLE BLVD EL PASO TX 79938 EL PASO 9158567349 670049 NORTH CENTRAL SURGICAL CENTER LLP 9301 NORTH CENTRAL EXPRESSWAY SUITE 100 DALLAS TX 75231 DALLAS 2142652810 670053 ST LUKE'S SUGAR LAND HOSPITAL 1317 LAKE POINTE PARKWAY SUGAR LAND TX 77478 FORT BEND 2816377000 670054 FOUNDATION SURGICAL HOSPITAL OF SAN ANTONIO 9522 HUEBNER ROAD SAN ANTONIO TX 78240 BEXAR 2104785400 670055 METHODIST STONE OAK HOSPITAL 1139 E SONTERRA BLVD SAN ANTONIO TX 78258 BEXAR 2106382100 670056 SETON MEDICAL CENTER HAYS 6001 KYLE PKWY KYLE TX 78640 HAYS 5123245000 670058 EMERUS HOSPITAL 16000 SOUTHWEST FREEWAY SUGAR LAND TX 77479 FORT BEND 2815160911 670059 ST LUKES LAKESIDE HOSPITAL 17400 ST LUKES WAY THE WOODLANDS TX 77384 MONTGOMERY 9362664055 670060 BAYLOR SCOTT AND WHITE MEDICAL CENTER SUNNYVALE 231 SOUTH COLLINS ROAD SUNNYVALE TX 75182 DALLAS 9728923000
670061 SOUTH TEXAS SURGICAL HOSPITAL 6130 PARKWAY DRIVE CORPUS CHRISTI TX 78414 NUECES 3619932000 670062 BAYLOR EMERGENCY MEDICAL CENTER 26791 HIGHWAY 380 AUBREY TX 76227 DENTON 9723472525 670067 BAYLOR ORTHOPEDIC AND SPINE HOSPITAL AT ARLINGTON 707 HIGHLANDER BLVD ARLINGTON TX 76015 TARRANT 8175492364
670068 TEXAS HEALTH PRESBYTERIAN HOSPITAL FLOWER MOUND 4400 LONG PRAIRIE ROAD FLOWER MOUND TX 75028 DENTON 9724191530
670069 METHODIST MCKINNEY HOSPITAL 8000 W ELDORADO PKWY MCKINNEY TX 75070 COLLIN 4694246400 670070 TEXAS SPECIALTY HOSPITAL AT LUBBOCK 4302 B PRINCTON STREET LUBBOCK TX 79415 LUBBOCK 8067123870 670071 TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON 811 WRIGHT STREET ARLINGTON TX 76012 TARRANT 8179603500
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 237 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 670072 HOPEBRIDGE HOSPITAL 5556 GASMER DRIVE HOUSTON TX 77035 HARRIS 7134222650 670073 METHODIST HOSPITAL FOR SURGERY 17101 DALLAS PARKWAY ADDISON TX 75001 DALLAS 4692483900 670075 ST LUKE'S HOSPITAL AT THE VINTAGE 20171 CHASEWOOD PARK DRIVE HOUSTON TX 77070 HARRIS 8325345000 670076 BAYLOR SCOTT AND WHITE SURGICAL HOSPITAL AT 3601 CALAIS DRIVE SHERMAN TX 75090 GRAYSON 9038133728 SHERMA 670077 METHODIST WEST HOUSTON HOSPITAL 18500 KATY FREEWAY HOUSTON TX 77094 HARRIS 8325221000 670078 BAPTIST EMERGENCY HOSPITAL 16088 SAN PEDRO SAN ANTONIO TX 78232 BEXAR 2104024092 670079 LAKEWAY REGIONAL MEDICAL CENTER, LLC 100 MEDICAL PARKWAY LAKEWAY TX 78734 TRAVIS 5122058102 670080 SETON MEDICAL CENTER HARKER HEIGHTS 850 W CENTRAL TEXAS EXPRESSWAY HARKER HEIGHTS TX 76548 BELL 2549538342 670082 BAYLOR SCOTT AND WHITE MEDICAL CENTER MCKINNEY 5252 WEST UNIVERSITY DRIVE MC KINNEY TX 75071 COLLIN 4697642200
670083 TEXAS GENERAL HOSPITAL 2709 HOSPITAL BLVD GRAND PRAIRIE TX 75051 DALLAS 4696352073 670085 TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE 10864 TEXAS HEALTH TRAIL FORT WORTH TX 76244 TARRANT 6822122000
670087 BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER AT 900 EAST WHITESTONE BLVD CEDAR PARK TX 78613 WILLIAMSON 5126844911 C 670088 BAYLOR SCOTT & WHITE MEDICAL CENTER‐ COLLEGE STATI 700 SCOTT & WHITE DRIVE COLLEGE STATION TX 77845 BRAZOS 9796913701
670089 NIX COMMUNITY GENERAL HOSPITAL 230 WEST MILLER STREET DILLEY TX 78017 FRIO 2102712190 670090 CRESCENT MEDICAL CENTER LANCASTER 2600 WEST PLEASANT RUN ROAD LANCASTER TX 75146 DALLAS 9722308888 670092 WALNUT HILL MEDICAL CENTER 7502 GREENVILLE AVENUE DALLAS TX 75231 DALLAS 9728636000 670093 ASPIRE BEHAVIORAL HEALTH OF CONROE, LLC 2006 SOUTH LOOP 336 WEST, SUITE 500 CONROE TX 77304 MONTGOMERY 9366473500 670094 LITTLE RIVER HEALTHCARE CAMERON HOSPITAL 806 N CROCKETT AVE CAMERON TX 76520 MILAM 2546050025 670095 EMERUS COMMUNITY HOSPITAL 24429 TOMBALL PARKWAY, SUITE 100 TOMBALL TX 77375 HARRIS 2815160911 670096 BAY AREA REGIONAL MEDICAL CENTER, LLC 200 BLOSSOM STREET WEBSTER TX 77598 HARRIS 2815257000 670097 BAYLOR EMERGENCY MEDICAL CENTER 1975 ALPHA STE 100 ROCKWALL TX 75087 ROCKWALL 2142946200 670098 RESOLUTE HEALTH HOSPITAL 555 CREEKSIDE XING, NEW BRAUNFELS TX 78130 COMAL 4698396778 670099 EMIL J FREIREICH CANCER CENTER 9201 PINECROFT SHENANDOAH TX 77380 MONTGOMERY 8553532201 670102 AD HOSPITAL EAST, LLC 12950 EAST FREEWAY, SUITE 100 SHENANDOAH TX 77380 MONTGOMERY 7133303897 670103 MEDICAL CENTER OF ALLIANCE 3101 NORTH TARRANT PARKWAY FORT WORTH TX 76177 TARRANT 8176391100 670106 PEARLAND MEDICAL CENTER 11100 SHADOW CREEK PARKWAY PEARLAND TX 77584 BRAZORIA 7137707000 670107 BAYLOR EMERGENCY MEDICAL CENTER 12500 SOUTH FREEWAY SUITE 100 BURLESON TX 76028 JOHNSON 2142946250
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 238 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 670108 BAYLOR SCOTT & WHITE MEDICAL CENTER ‐ MARBLE FALLS 810 W HIGHWAY 71 MARBLE FALLS TX 78654 BURNET 8302017308
670109 ALTUS BAYTOWN HOSPITAL 1626 W BAKER RD BAYTOWN TX 77521 HARRIS 2818377600 670111 CONTINUECARE HOSPITAL AT MEDICAL CENTER ODESSA 500 WEST 4TH STREET , 4TH FLOOR ODESSA TX 79761 ECTOR 2176163297
670112 CUMBERLAND SURGICAL HOSPITAL 5330 NORTH LOOP 1604 WEST SAN ANTONIO TX 78249 BEXAR 7176202424 670114 WEIMAR MEDICAL CENTER 400 YOUENS DR WEIMAR TX 78962 COLORADO 9797258274 670115 CLEVELAND EMERGENCY HOSPTIAL 1017 S TRAVIS AVE CLEVELAND TX 77327 LIBERTY 2816595400 673025 PAM REHABILITATION HOSPITAL OF ALLEN 1001 RAINTREE CIRCLE ALLEN TX 75013 COLLIN 9729082015 673026 GULF STATES LTAC OF NEW BRAUNFELS 1445 HANZ DRIVE NEW BRAUNFELS TX 78130 COMAL 8306277600 673027 CENTRAL TEXAS REHABILITATION HOSPITAL 700 W 45TH ST AUSTIN TX 78705 TRAVIS 5124072101 673028 DALLAS LTACH LLC 8050 MEADOW ROAD DALLAS TX 75231 DALLAS 4692326500 673029 HEALTHSOUTH REHABILITAITON HOSPITAL OF 3351 WATERVIEW PARKWAY RICHARDSON TX 75080 DALLAS 9723985700 RICHARDSON 673030 KATE DISHMAN REHABILITATION HOSPITAL 2830 CALDER ST 6TH FL SOUTH BEAUMONT TX 77702 JEFFERSON 4098998380 673031 METHODIST REHABILITATION HOSPITAL 3020 WEST WHEATLAND ROAD DALLAS TX 75237 DALLAS 9727088600 673032 RELIANT REHABILITATION HOSPITAL OF CENTRAL TEXAS 1400 HESTER'S CROSSING ROUND ROCK TX 78681 WILLIAMSON 9723088517
673034 RELIANT REHABILITATION HOSPITAL NORTH HOUSTON 117 VISION PARK BLVD SHENANDOAH TX 77302 MONTGOMERY 9364441700
673035 BAYLOR INSTITUTE FOR REHABILITATION AT FORT WORTH 6601 HARRIS PARKWAY FORT WORTH TX 76132 TARRANT 2145250619
673036 SELECT REHABILITATION HOSPITAL OF DENTON 2620 SCRIPTURE STREET DENTON TX 76201 DENTON 9402976500 673038 MEMORIAL HERMANN REHABILITATION HOSPITAL KATY 21720 KINGSLAND BLVD, SUITE 102 KATY TX 77450 HARRIS 2815795678
673039 RELIANT REHABILITATION HOSPITAL ABILENE 6401 DIRECTORS PARKWAY ABILENE TX 79606 TAYLOR 3256911600 673040 SELECT REHABILITATION HOSPITAL OF SAN ANTONIO 19126 STONE HUE SAN ANTONIO TX 78258 BEXAR 2104823400 673041 CARRUS REHABILITATION HOSPITAL 1810 WEST HIGHWAY 82 SHERMAN TX 75092 GRAYSON 9038702600 673042 HEALTHSOUTH SUGAR LAND REHABILITATION HOSPITAL 1325 HWY 6SUGAR LAND TX 77478 FORT BEND 2812767599
673043 HEALTHSOUTH REHABILITATION HOSPITAL OF DALLAS 7930 NORTHAVEN ROAD DALLAS TX 75230 DALLAS 2147068200
673044 HEALTHSOUTH REHABILITATION HOSPITAL OF THE MIDCITI 2304 HIGHWAY 121 BEDFORD TX 76021 TARRANT 8176842000
673045 MESQUITE REHABILITATION INSTITUTE 1023 N BELTLINE ROAD MESQUITE TX 75149 DALLAS 9722162400
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 239 www.smainformatics.com Resources from SMA FY2017 IPPS Directory PROV PROVIDER NAME ADDRESS CITY ST ZIP COUNTY PHONE NUM 673046 BAYLOR INSTITUTE FOR REHABILITATION AT FRISCO 2990 LEGACY DRIVE FRISCO TX 75034 COLLIN 4698885100 673048 TEXAS REHABILITATION HOSPITAL 425 ALABAMA AVENUE FORT WORTH TX 76104 TARRANT 8178203400 673049 NEW BRAUNFELS REG REHAB HOSP INC 2041 SUNDANCE PARKWAY NEW BRAUNFELS TX 78130 COMAL 8306276700 673050 HEALTHSOUTH REHABILITATION HOSPITAL OF CYPRESS 13031 WORTHAM CENTER DRIVE HOUSTON TX 77065 HARRIS 8322802500
673051 KINDRED REHABILITATION HOSPITAL NORTHEAST 18839 MCKAY BOULEVARD HUMBLE TX 77338 HARRIS 2814463655 HOUSTON 673052 HEALTHSOUTH REHABILITATION HOSPITAL THE VINTAGE 20180 CHASEWOOD PARK DRIVE HOUSTON TX 77070 HARRIS 9723088567
673053 CORPUS CHRISTI REHABILITATION HOSPITAL LLC 5726 ESPLANADE DRIVE CORPUS CHRISTI TX 78414 NUECES 3619911007 673054 HEALTHSOUTH REHABILITATION HOSPITAL ‐ SOUTH AUSTIN 330 W BEN WHITE BLVD AUSTIN TX 78704 TRAVIS 9723088567
673055 ACCEL REHABILITATION HOSPITAL OF PLANO 2301 MARSH LANE SUITE 200 PLANO TX 75093 COLLIN 9728995510 673056 WARM SPRINGS REHABILITATION HOSPITAL OF VICTORIA 101 JAMES COLEMAN DRIVE VICTORIA TX 77904 VICTORIA 3618947830
673057 WARM SPRINGS REHABILITATION HOSPITAL OF KYLE 5980 KYLE PARKWAY KYLE TX 78640 HAYS 5122620821 673058 VIBRA REHABILITATION HOSPITAL OF LAKE TRAVIS 2000 MEDICAL DRIVE LAKEWAY TX 78734 TRAVIS 5122634500 673059 LAREDO REHABILITATION HOSPITAL, LLC 2005 A BUSTAMANTE STREET LAREDO TX 78041 WEBB 9567648555 673060 TEXAS REHABILITATION HOSPITAL OF ARLINGTON 900 W ARBROOK BLVD ARLINGTON TX 76015 TARRANT 6823089867 673061 BAY AREA REHABILITATION HOSPITAL 110 EAST MEDICAL CENTER BLVD WEBSTER TX 77598 HARRIS 8322249500 673062 WEATHERFORD REHABILITATION HOSPITAL LLC 703 EUREKA STREET WEATHERFORD TX 76086 PARKER 6828030100 673063 TRUSTPOINT REHAB HOSPITAL OF LUBBOCK 4302 PRINCETON LUBBOCK TX 79415 LUBBOCK 8067408413 673064 ICARE REHABILITATION HOSPITAL 3100 PETERS COLONY ROAD FLOWER MOUND TX 75022 DENTON 2145130310
SMA Informatics, 800 E. Leigh St., Suite 206‐14, Richmond,VA 23219, (804) 344‐8111 SMA Informatics Confidential Page 240 www.smainformatics.com