NPIMap

Organization Active NPI

Mercy Assisted Care, Inc

Doing business as Mercy Health AtHome

  • Community Based Hospice Care Agency
  • Janesville, WI
National Provider Identifier
1104971050
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
544 Issued in WI
Legal business name
MERCY ASSISTED CARE, INC
Doing business as
Mercy Health AtHome
Practice address
901 Mineral Point Ave
Janesville, WI 53548-2970
Phone
(608) 754-2201
NPI assigned
Jan 23, 2007
Last updated
Sep 30, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Authorized official

Name
Patricia Lynne Allen
Title
Cfo
Phone
(608) 756-6080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 544 WI Primary

Addresses

Primary practice location

901 Mineral Point Ave
Janesville, WI 53548-2970

Mailing address

901 Mineral Point Ave
Janesville, WI 53548-2970
Phone (608) 754-2201

Other identifiers 1

IdentifierTypeStateIssuer
43185200MedicaidWI

Other names 1

  • Mercy Health AtHome Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071112000267 WI Part A Provider - Hospice 0749383487 Practice locations: Janesville, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104971050. Details of each certification follow.

Hospice certification: CCN 521550

Legal name
MERCY ASSISTED CARE, INC
Doing business as
MERCYHEALTH AT HOME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 18, 1994
Last certification
Mar 9, 2022
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Sep 29, 1964 in WI
Enrollment address
901 Mineral Point Ave
Janesville, WI 53548-2970

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Mercyhealth at HomeCCN 521550 · All quality measures
Ownership
Non-Profit
Certified
Feb 18, 1994
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Mercy Assisted Care Inc7 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.

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Dave L Syverson Individual Corporate DirectorBoard of Directors Jan 1, 2016
Kathi J Palches Individual W-2 Managing EmployeeFacility Credentialing Coordinator Apr 28, 2015
Ali Olia Individual Corporate OfficerVP Information Systems Nov 1, 2021
Shannon Dunphy-Alexander Individual Corporate OfficerCfo Dec 1, 2024
W-2 Managing EmployeeCfo Mar 11, 2018
Kara Sankey Individual Corporate OfficerVP Operations Apr 1, 2021
Jennifer a Hallatt Individual Corporate OfficerVP Clinics Jan 1, 2012
W-2 Managing EmployeeAd; Jan 1, 2012
Carlos Arevalo Individual Corporate DirectorBoard Member Oct 16, 2024
Mercy Health Corporation Organization, Rockford, IL Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2015 100%
Thomas D Budd Individual Corporate DirectorBoard Secretary/Treasurer Jan 1, 2016
John T Dorsey Individual Corporate OfficerVP & Director of Medical Affairs Aug 20, 2012
Katherine a Schack Individual Corporate DirectorBoard of Directors Sep 1, 2016
Joanna Benning Individual Corporate OfficerVP Facilities Mar 15, 2015
Robert Brinkerhoff Individual Corporate OfficerVP People & Culture Feb 19, 2024
Edward P Cranley Individual Corporate OfficerSenior VP Nov 30, 2014
Bradley Olson Individual Corporate OfficerVP Managed Care Sep 25, 2023
Mark L Goelzer Individual Corporate OfficerVP & Director of Medical Affairs Jan 1, 2016
Corporate DirectorBoard of Directors Jan 1, 2016
W-2 Managing EmployeeMD; Jan 1, 2016
Kimberly Scaccia Individual Corporate OfficerVP Revenue Cycle Mar 23, 2020
W-2 Managing EmployeeVP Revenue Cycle Mar 23, 2020
Wesley M Jost Individual Corporate DirectorBoard of Directors Sep 1, 2016
Tyler Killpack Individual Corporate OfficerVP Community Hospitals Aug 1, 2023
Amy Whitaker Individual Corporate OfficerVP Supply Chain Aug 1, 2022
Thomas R Pool Individual Corporate DirectorBoard Vice Chair Jan 1, 2016
Ladd Udy Individual Corporate OfficerVP Value Based Care & Pop Health Nov 10, 2018
Javon R Bea Individual Corporate OfficerPresident & Ceo Apr 28, 2015
Corporate DirectorPresident/Ceo Jul 1, 1990

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 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790726400000",
    "number": "1104971050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-754-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-754-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY ASSISTED CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH  CORPORATION",
        "enumeration_date": "2007-01-23",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-756-6080"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": "544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43185200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Health AtHome",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.