Mercy Hospital Kingfisher, Inc
Organization Active NPI Critical Access Hospital · Kingfisher, OK
NPI 1083048417 · NPPES record last updated Aug 30, 2021
Key facts
- NPI
- 1083048417
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 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
- Organization subpart
- No
Authorized official
- Name
- Sherry Lynn Clouse Day
- Title
- VP Finance
- Phone
- (417) 820-8439
Owners & managing parties with NPI records 8
-
Jeffrey Peter Ciaramita, M.D.
-
John M Mohart, M.D.
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 1
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 120
Practitioners 68
-
Travis Clark Garrett, M.D.
-
Christopher Jared Howard, APRN-CNP
-
Lirin Jacob, M.D.
-
Caleb King, MD
-
Ariel Erik Santos Lufkin, M.D.
-
Kenna Sue Wenthold, ARNP
-
Daniel Ian Pascucci, M.D.
-
Brian Baker, D.O.
-
Christopher Lee Bass, D.O.
-
Brandon Stephen Brown, M.D.
-
John Cloud, D.O.
-
Jerome Dario Aldo Dinan, PA-C
-
Andrew Michael Eaton, D.O.
-
Thomas Frasier Engle, PA-C
-
Crystalle M Evans, D.O.
-
Jami Grantz, APRN, CNP
-
Helen Harris, D.O.
-
Chad N Hudson, P.A.
-
Koby Hunter, DO
Affiliated clinicians 95
-
Jean Abed, M.D.
-
Nicholas Anastas, DO
-
Cody M. Anderson, MD
-
Stephen Arthurs, MD
-
Daniel P Barnes, M.D.
-
Cortney Barrett, NP
-
Katrina Bates, APRN
-
Steven Brantley, MD
-
Heather Patricia Bullock, PA-C
-
Kandice Burk, APRN, FNP-C
-
Beau James Burton, P.A.-C
-
Chasity Jane Butler, PA-C
-
Amy R Cavner, APRN-CNP
-
John Crow, MD
Medicare Care Compare: Hospital
- Listed as
- Mercy Hospital Kingfisher, Inc
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
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
- Corporation · Non-profit
- Incorporated
- Aug 13, 2013 in OK
- Enrollment address
- 1000 Hospital Dr
Kingfisher, OK 73750-5029
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| John M Mohart |
Corporate Director | Jul 1, 2021 | |
| Erin Scammahorn |
Corporate Director |
Jul 1, 2021 | |
| Cheryl L Matejka |
Operational/Managerial Control |
Jul 1, 2021 | |
| Yogya Regmi |
W-2 Managing Employee | Aug 29, 2022 | |
| Chelsea Williams |
Corporate Director |
Jul 1, 2021 | |
| Jeffrey Peter Ciaramita |
Corporate Director | Jul 1, 2021 | |
| Christie Eckhardt |
Corporate Officer |
Jul 1, 2021 | |
| Mercy Health |
Operational/Managerial Control | Nov 2, 2013 | 100% |
| Mercy Health Oklahoma Communities |
5% Or Greater Indirect Ownership Interest | Nov 1, 2013 | 100% |
| Mercy Hospital Oklahoma City, Inc |
5% Or Greater Direct Ownership Interest | Nov 1, 2013 | 100% |
| Sherry Clouse Day |
Corporate Officer |
Jan 1, 2021 | |
| W-2 Managing Employee |
Jan 1, 2021 | ||
| Bobby J Stitt |
Corporate Officer |
Jul 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131104000084 | OK | Part a Provider - Critical Access Hospital | 5395970180 |
Receives reassigned benefits from 58 practitioners Practice locations: Kingfisher, OK |
National Provider Directory
- Tax ID family
- Mercy Hospital Kingfisher Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | |||
| Critical Access Hospital | 282NC0060X | Yes |
Addresses
Primary practice location
1000 Hospital Dr
Kingfisher, OK 73750-5029
Mailing address
1000 Hospital Dr
Kingfisher, OK 73750-5029
Phone (405) 375-3141
Other providers in Kingfisher, OK
- LTRX Inc.
- Stephanie Luecke
- Kaden Marshall
- Robin L Matson
- Gerald W. McMullin
- Mercy Hospital Kingfisher, Inc
- Mercy Hospital Kingfisher, Inc
- Diane Marie Minnis
- Susan Murray
- Blanca Lorena Najera
All providers in Kingfisher, OK · Critical Access Hospital in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.