NPIMap

Organization Active NPI

Mercy Hospital Lincoln

Doing business as Mercy Hospital Lincoln- Family Medicine

  • Rural Health Clinic/Center
  • Troy, MO
National Provider Identifier
1144626219
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MERCY HOSPITAL LINCOLN
Doing business as
Mercy Hospital Lincoln- Family Medicine
Practice address
900 E Cherry St
Troy, MO 63379-1429
Phone
(636) 528-8585
NPI assigned
Nov 17, 2014
Last updated
Sep 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Mr. Mark Thorn
Title
Executive Director Finance
Phone
(636) 528-3329

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

900 E Cherry St
Troy, MO 63379-1429

Mailing address

900 E Cherry St
Troy, MO 63379-1429
Phone (636) 528-8585

Other names 1

  • MERCY HOSPITAL LINCOLN- FAMILY MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150218002078 MO Part A Provider - Rural Health Clinic 5193040020 Practice locations: Troy, MO
O20150623002541 MO Part B Supplier - Clinic/Group Practice 5193040020 Receives reassigned benefits from 232 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elsberry, MO; Troy, MO; Winfield, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144626219. Details of each certification follow.

Rural health clinic certification: CCN 263457

Legal name
MERCY HOSPITAL LINCOLN
Doing business as
MERCY HOSPITAL LINCOLN- FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 26, 1995
Last certification
Apr 26, 2023
Ownership / control type
2B
Most recent change of ownership
Mar 1, 2015 (1 total)
Organization structure
CorporationNon-profit
Enrollment address
900 E Cherry St
Troy, MO 63379-1429
Related CCNs
261319

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

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 19

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

NameRoleSinceShare
Suzette Morris Individual Corporate DirectorBoard Member Apr 27, 2025
Jamie Wilke Individual Corporate OfficerSecretary Jul 1, 2024
Mercy Hospitals East Communities Organization, Saint Louis, MO Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 1, 2015 100%
Claudia Ward Individual Corporate Director Jul 1, 2021
Annette S Meyer Individual Corporate DirectorBoard Member Jul 1, 2022
Sarah Burkemper Individual Corporate DirectorBoard Member Jul 1, 2021
Mark a Thorn Individual Corporate OfficerTreasurer Jul 1, 2021
W-2 Managing EmployeeExecutive Director of Finance Mar 1, 2015
John Barry Kelly Individual Corporate Director Jul 1, 2021
Anthony Rothermich Individual Corporate OfficerPresident Mar 1, 2015
Timothy L Reller Individual Corporate DirectorBoard Member Jul 1, 2020
Bradley J Massey Individual Corporate DirectorBoard Member Jul 1, 2020
Stacie Farnam Individual W-2 Managing EmployeeDirector Jul 8, 2022
Mercy Health Organization, Chesterfield, MO Corporation, Non-profit, Chain home office Operational/Managerial Control Mar 2, 2015 100%
David J Meiners Individual Corporate DirectorBoard Member Jul 1, 2022
Harvey D Rhoads Individual Corporate DirectorBoard Member Nov 19, 2019
Mark Penny Individual Corporate DirectorBoard Member Jul 1, 2020
Mercy Health East Communities Organization, Saint Louis, MO Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 2, 2015 100%
Rod Hamlett Individual Corporate DirectorBoard Member Apr 27, 2025
Brian Day Individual Corporate OfficerSVP Apr 27, 2025

Owners & managing parties with NPI records 6

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

Facilities with the same owner 117

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

View all 117

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1144626219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791429",
            "telephone_number": "636-528-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791429",
            "telephone_number": "636-528-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL LINCOLN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-17",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "THORN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR FINANCE",
        "authorized_official_telephone_number": "636-528-3329",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY HOSPITAL LINCOLN- FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.