NPIMap

Organization Active NPI

Mercy Hospital Booneville

  • Certified Registered Nurse Anesthetist
  • Booneville, AR
National Provider Identifier
1083004733
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MERCY HOSPITAL BOONEVILLE
Practice address
880 W Main St
Booneville, AR 72927-3443
Phone
(479) 675-2800
NPI assigned
Feb 3, 2015
Last updated
May 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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
Phone
(417) 820-8439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

880 W Main St
Booneville, AR 72927-3443

Mailing address

880 W Main St
Booneville, AR 72927-3443
Phone (479) 675-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170203001490 AR Part B Supplier - Clinic/Group Practice 1951530385 Receives reassigned benefits from 142 practitioners
3 other NPIs on this enrollment
Practice locations: Magazine, AR; Booneville, AR

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

880 W Main St
Booneville, AR 72927
Phone (479) 675-2800

351 E Priddy St
Magazine, AR 72943
Phone (479) 969-8640

Practitioners & affiliated clinicians

Practitioners 143

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 143

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1083004733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W MAIN ST",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273443",
            "telephone_number": "479-675-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W MAIN ST",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273443",
            "telephone_number": "479-675-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL BOONEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.