NPIMap

Organization Active NPI

Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
National Provider Identifier
1063117158
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MERCY HOSPITAL PERRY
Practice address
434 N West St
Perryville, MO 63775-1359
Phone
(417) 820-8439
NPI assigned
Mar 30, 2023
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Sherry Clouse Day
Title
VP Finance Mercy Cah
Phone
(417) 820-8439

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Diagnostic Radiology Physician 2085R0202X NU
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

434 N West St
Perryville, MO 63775-1359

Mailing address

434 N West St
Perryville, MO 63775-1359

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231101001515 MO Part B Supplier - Clinic/Group Practice 1153777826 Receives reassigned benefits from 194 practitioners
4 other NPIs on this enrollment
Practice locations: Perryville, MO
O20231106001433 MO Part A Provider - Critical Access Hospital 1153777826 Receives reassigned benefits from 106 practitioners
Practice locations: Perryville, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063117158. Details of each certification follow.

Hospital certification: CCN 261311

Legal name
MERCY HOSPITAL PERRY
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2001
Last certification
Nov 12, 2014
Beds
25
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 1, 2023 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 2023 in MO
Enrollment address
434 N West St
Perryville, MO 63775-1359
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercy Hospital PerryCCN 261311 · All quality measures
Overall star rating
2 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

212 Hospital Ln
Ste 200
Perryville, MO 63775
Phone (573) 768-3410

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Gary Schumer Individual Corporate DirectorBoard Member Oct 1, 2023
Daniel S Eckenfels Individual Corporate DirectorBoard Member Oct 1, 2023
Jamie Wilke Individual Corporate OfficerSecretary Jul 1, 2024
Gregory Unger Individual Corporate DirectorBoard Member Oct 1, 2023
Robin Simms Individual Corporate DirectorBoard Member Oct 1, 2023
Sandeep C Rao Individual Corporate DirectorBoard Member Oct 1, 2023
Christopher Wibbenmeyer Individual Corporate OfficerPresident Oct 1, 2023
W-2 Managing EmployeePresident Oct 1, 2023
Matthew D Gaeta Individual Corporate DirectorBoard Member Oct 1, 2023
Linda Buerck Individual Corporate DirectorBoard Member Oct 1, 2023
Stacie Farnam Individual W-2 Managing EmployeeDirector Oct 1, 2023
Mercy Health Organization, Chesterfield, MO Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Oct 1, 2023 100%
Craig Hayden Individual Corporate DirectorChairman Oct 1, 2023
Ryan E Johnston Individual Corporate DirectorBoard Member Oct 1, 2023
Kay Taylor Individual Corporate DirectorBoard Member Oct 1, 2023
Mercy Health East Communities Organization, Saint Louis, MO Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2023 100%
Robert a Patrick Individual Corporate DirectorBoard Member Oct 1, 2023
Patrick Naeger Individual Corporate DirectorBoard Member Oct 1, 2023
Sherry Clouse Day Individual Corporate OfficerTreasurer Oct 1, 2023
Brian Day Individual Corporate OfficerSenior Vice President Sep 15, 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 116

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

View all 116

Practitioners & affiliated clinicians

Practitioners 196

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 196

Affiliated clinicians 211

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

View all 211

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1063117158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 N WEST ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 N WEST ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751359",
            "telephone_number": "417-820-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL PERRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "VP FINANCE MERCY CAH",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MO

Sources for this page

Verify at the official NPI Registry.