NPIMap

Organization Active NPI

Mercy Medical Health Center

  • Federally Qualified Health Center (FQHC)
  • Jonesboro, LA
National Provider Identifier
1063945434
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MERCY MEDICAL HEALTH CENTER
Practice address
244 Bond St
Jonesboro, LA 71251-5334
Phone
(318) 259-1100
Fax
(318) 259-1333
NPI assigned
Apr 4, 2017
Last updated
Jun 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Kimberly G. Brunson, FNP, APRNNPI 1477785798
Title
Ceo, NP
Phone
(318) 259-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

244 Bond St
Jonesboro, LA 71251-5334

Mailing address

PO Box 70
Hodge, LA 71247-0070
Phone (318) 259-1100

Other identifiers 1

IdentifierTypeStateIssuer
2468588MedicaidLA

Other names 1

  • Mercy Medical LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170614000398 LA Part B Supplier - Clinic/Group Practice 1557639655 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
Practice locations: Arcadia, LA; Jonesboro, LA; Ruston, LA
O20181126000048 LA Part A Provider - Federally Qualified Health Center (FQHC) 1557639655 Practice locations: Jonesboro, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063945434. Details of each certification follow.

Federally qualified health center certification: CCN 191007

Legal name
MERCY MEDICAL HEALTH CENTER
Doing business as
MERCY MEDICAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 20, 2018
Last certification
Nov 20, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 5, 2017 in LA
Enrollment address
244 Bond St
Jonesboro, LA 71251-5334

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Health Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17704/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Mercy Medical Health Center Organization, Jonesboro, LA Corporation, Non-profit Operational/Managerial Control Sep 5, 2017 100%
Kimberly Brunson Individual Operational/Managerial ControlCeo May 1, 2017
Rennata Becks Individual W-2 Managing Employee May 1, 2018

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy DentalRuston, LA, CCN 951002 Federally qualified health center Other (100%) Jan 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1063945434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "HODGE",
            "state": "LA",
            "postal_code": "712470070",
            "telephone_number": "318-259-1100",
            "fax_number": "318-259-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 BOND ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712515334",
            "telephone_number": "318-259-1100",
            "fax_number": "318-259-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "BRUNSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO, NP",
        "authorized_official_telephone_number": "318-259-1100",
        "authorized_official_credential": "FNP, APRN"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2468588",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Medical LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Mercy Medical LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jonesboro, LA

Sources for this page

Verify at the official NPI Registry.