NPIMap

Mercy Hospital Carthage

Organization Active NPI Critical Access Hospital · Carthage, MO

NPI 1003201955 · NPPES record last updated Sep 17, 2020

Key facts

NPI
1003201955
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 2

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

Other NPIs on the same Medicare enrollment 5

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

Other NPIs with the same Medicare PAC ID 3

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

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

Facilities with the same owner 114

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

View all 114

Practitioners 184

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 184

Affiliated clinicians 290

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

View all 290

Medicare Care Compare: Hospital

Listed as
Mercy Hospital Carthage CCN 261338
Overall star rating
★★★★☆ 4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MO

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
Corporation · Non-profit
Enrollment address
3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Other Hospital Practice Location

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 Officer
Secretary		 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 Officer
President		 Sep 1, 2025
Jeffrey Peter Ciaramita
Individual 		Corporate Director Jul 1, 2021
Belinda Farmer
Individual 		Corporate Director
Board 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 Officer
Treasurer		 Aug 14, 2020
Brian Day
Individual 		Corporate Officer
Senior Vice President		 Sep 1, 2025

Medicare enrollment records

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

National Provider Directory

Locations

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

Specialties & licenses

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

Other identifiers

IdentifierTypeStateIssuer
200446020AMedicaidOK
01067090MedicaidMO
203923105MedicaidAR
200972980AMedicaidKS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 17, 2020.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200446020A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01067090",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203923105",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200972980A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MO

All providers in Carthage, MO · Critical Access Hospital in Missouri

Sources for this page

Verify at the official NPI Registry.