Mary'S Mercy Center

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

MARY'S MERCY CENTER

Practice address

641 Roberds Ave
San Bernardino, CA 92411-2681

Phone

(909) 889-2558

NPI assigned

Dec 16, 2024

Organization subpart

No

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

Authorized official

Name

Dan Flores

Title

Dan Flores Executive Director

Phone

(909) 889-2558

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Tonette Jones

  • Community Health Worker
  • San Bernardino, CA
  • NPI 1124858048
  NPD
• Sandi Roberts

  • Community Health Worker
  • San Bernardino, CA
  • NPI 1508758053
  NPD

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1013724822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 ROBERDS AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924112681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 ROBERDS AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924112681",
            "telephone_number": "909-889-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S MERCY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "DAN FLORES EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-889-2558"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Martinez
• Vivian Martinez
• Wendy Martinez
• Jose M Martorell, DDS
• Meshawn L Marts
• Joshua Joseph Masih, PMHNP
• Prianthi Masilamani, MHS
• Melody Marie Mason
• Alisha Massengale
• Myron Lloyd Massey, DDS

• Community Health Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.