NPIMap

Organization Active NPI

Mercy Hospital Kingfisher, Inc

  • Critical Access Hospital
  • Kingfisher, OK
National Provider Identifier
1083048417
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MERCY HOSPITAL KINGFISHER, INC
Practice address
1000 Hospital Dr
Kingfisher, OK 73750-5029
Phone
(405) 375-3141
NPI assigned
Aug 21, 2013
Last updated
Aug 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

1000 Hospital Dr
Kingfisher, OK 73750-5029

Mailing address

1000 Hospital Dr
Kingfisher, OK 73750-5029
Phone (405) 375-3141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131104000084 OK Part A Provider - Critical Access Hospital 5395970180 Receives reassigned benefits from 58 practitioners
Practice locations: Kingfisher, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083048417. Details of each certification follow.

Hospital certification: CCN 371313

Legal name
MERCY HOSPITAL KINGFISHER, INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2000
Last certification
Mar 6, 2024
Beds
25
Ownership / control type
Private (not for profit)
Most recent change of ownership
Nov 1, 2013 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 13, 2013 in OK
Enrollment address
1000 Hospital Dr
Kingfisher, OK 73750-5029
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercy Hospital Kingfisher, IncCCN 371313 · All quality measures
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
Tax ID family
Mercy Hospital Kingfisher Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
John M Mohart Individual Corporate Director Jul 1, 2021
Erin Scammahorn Individual Corporate DirectorBoard Member Jul 1, 2021
Cheryl L Matejka Individual Operational/Managerial ControlSVP-Cfo Jul 1, 2021
Yogya Regmi Individual W-2 Managing Employee Aug 29, 2022
Chelsea Williams Individual Corporate DirectorBoard Member Jul 1, 2021
Jeffrey Peter Ciaramita Individual Corporate Director Jul 1, 2021
Christie Eckhardt Individual Corporate OfficerSecretary Jul 1, 2021
Mercy Health Organization, Chesterfield, MO Corporation, Non-profit Operational/Managerial Control Nov 2, 2013 100%
Mercy Health Oklahoma Communities Organization, Chesterfield, MO Non-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2013 100%
Mercy Hospital Oklahoma City, Inc Organization, Oklahoma City, OK Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2013 100%
Sherry Clouse Day Individual Corporate OfficerTreasurer Jan 1, 2021
W-2 Managing EmployeeVP of Finance-Cah Jan 1, 2021
Bobby J Stitt Individual Corporate OfficerPresident Jul 1, 2021

Owners & managing parties with NPI records 8

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

Facilities with the same owner 120

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

View all 120

Practitioners & affiliated clinicians

Practitioners 65

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 65

Affiliated clinicians 95

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

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1083048417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOSPITAL DR",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737505029",
            "telephone_number": "405-375-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOSPITAL DR",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737505029",
            "telephone_number": "405-375-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL KINGFISHER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingfisher, OK

Sources for this page

Verify at the official NPI Registry.