Mercy Medical, a Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12474 Issued in AL

Legal business name

MERCY MEDICAL, A CORPORATION

Practice address

101 Villa Dr
Daphne, AL 36526-4653

Phone

(251) 621-4431

Fax

(251) 621-4899

NPI assigned

Apr 18, 2006

Organization subpart

No

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

Authorized official

Name

Jake Bell

Title

Chief Executive Officer

Phone

(251) 621-4223

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1124083761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365261090",
            "telephone_number": "251-621-4431",
            "fax_number": "251-621-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 VILLA DR",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264653",
            "telephone_number": "251-621-4431",
            "fax_number": "251-621-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL, A CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "251-621-4223"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC SNF PROVIDER NUM DAPHN",
            "identifier": "010347",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSPRING PROVIDER NUM",
            "identifier": "9245",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mercy Medical, a Corporation
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• Skilled Nursing Facility in Daphne, AL
• Providers in Daphne, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.