Mercy Health System Corporation

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

310-800 Issued in WI

Legal business name

MERCY HEALTH SYSTEM CORPORATION

Doing business as

Mercy Edgerton Medical Center

Practice address

217 N Main St
Edgerton, WI 53534-1613

Phone

(608) 884-9431

NPI assigned

Mar 9, 2007

Last updated

Feb 23, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

MERCYROCKFORD HEALTH SYSTEM CORPORATIONAs reported in NPPES

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

Authorized official

Name

John W Cook

Title

Senior VP/Cfo

Phone

(608) 756-6000

Specialties & licenses 1

Addresses

Other names 1

• MERCY EDGERTON MEDICAL CENTER Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1124159165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N MAIN ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341613",
            "telephone_number": "608-884-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH SYSTEM CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCYROCKFORD HEALTH SYSTEM CORPORATION",
        "enumeration_date": "2007-03-09",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "608-756-6000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "310-800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY EDGERTON MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krystal Lucas, LCSW, MSW, CAPSW
• Julie Louise Lyerla, PAC
• Sandra K Matzke, APNP
• Rachael McGauley
• Donna Lee Meister, LPN
• Aaron Peter Mertes, PHD, LPC-IT, CRC
• Amy D. Millard, NP
• Robert Newell Miller IV, MD
• Milton & Edgerton Vision Centers, LLC (Edgerton Vision Center)
• Anna Mirkes

• Durable Medical Equipment & Medical Supplies in Edgerton, WI
• Providers in Edgerton, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.