NPIMap

Organization Active NPI

Mercy Hospital Carthage

  • Critical Access Hospital
  • Carthage, MO
National Provider Identifier
1003201955
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MERCY HOSPITAL CARTHAGE
Practice address
3125 Dr Russell Smith Way
Carthage, MO 64836
Phone
(417) 358-8121
NPI assigned
Mar 30, 2015
Last updated
Sep 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sherry Lynn Clouse Day, AO
Title
Cfo
Phone
(417) 820-8439

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 523-4 MO
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 523-4 MO
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X 523-4 MO
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 523-4 MO
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 523-4 MO
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 523-4 MO
Critical Access Hospital 282NC0060X Primary
Land Ambulance 3416L0300X

Addresses

Primary practice location

3125 Dr Russell Smith Way
Carthage, MO 64836

Mailing address

3125 Dr Russell Smith Way
Carthage, MO 64836-7402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120225000071 MO Part B Supplier - Clinic/Group Practice 8426225251 Receives reassigned benefits from 134 practitioners
5 other NPIs on this enrollment
Practice locations: Carthage, MO
O20141203001963 MO Part A Provider - Critical Access Hospital 8426225251 Receives reassigned benefits from 152 practitioners
1 other NPI on this enrollment
Practice locations: Carthage, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003201955. Details of each certification follow.

Hospital certification: CCN 261338

Legal name
MERCY HOSPITAL CARTHAGE
Doing business as
MERCY HOSPITAL CARTHAGE
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 5, 2015
Last certification
May 22, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercy Hospital CarthageCCN 261338 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

3114 Medical Park Dr
Carthage, MO 64836
Phone (417) 358-0188

3116 Medical Park Dr
Carthage, MO 64836
Phone (417) 358-7574

645 Maryville Centre Dr
Fl 3
Saint Louis, MO 63141

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jamie Wilke Individual Corporate OfficerSecretary Jul 1, 2024
Mercy Health Southwest Missouri Kansas Communities Organization, Joplin, MO Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2012 100%
Shannon Sock Individual Corporate Director Jul 1, 2021
John M Mohart Individual Corporate Director Jul 2, 2021
Jeremy S Drinkwitz Individual Corporate OfficerPresident Sep 1, 2025
Jeffrey Peter Ciaramita Individual Corporate Director Jul 1, 2021
Belinda Farmer Individual Corporate DirectorBoard Member Sep 1, 2025
Stacie Farnam Individual W-2 Managing Employee Jan 1, 2021
Mercy Health Organization, Chesterfield, MO Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Nov 2, 2009 100%
Sherry Clouse Day Individual Corporate OfficerTreasurer Aug 14, 2020
Brian Day Individual Corporate OfficerSenior Vice President Sep 1, 2025

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 114

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 114

Practitioners & affiliated clinicians

Practitioners 184

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 184

Affiliated clinicians 290

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 290

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1003201955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 DR RUSSELL SMITH WAY",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648367402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 DR RUSSELL SMITH WAY",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "64836",
            "telephone_number": "417-358-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL CARTHAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-820-8439",
        "authorized_official_credential": "AO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "523-4",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "523-4",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "523-4",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "523-4",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "523-4",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MO",
            "license": "523-4",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MO

Sources for this page

Verify at the official NPI Registry.