NPIMap

Organization Active NPI

Mercy Health Clinics,LLC

Doing business as Mercy Health Clinic II

  • Rural Health Clinic/Center
  • Irvine, KY
National Provider Identifier
1215167432
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MERCY HEALTH CLINICS,LLC
Doing business as
Mercy Health Clinic II
Practice address
105 Main St
Irvine, KY 40336-1023
Phone
(606) 723-7771
Fax
(606) 723-4364
NPI assigned
Jul 22, 2009
Last updated
May 2, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
MARCUM AND WALLACE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Ms. Trena Lynn Stocker
Title
President
Phone
(859) 779-0148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

105 Main St
Irvine, KY 40336-1023

Mailing address

PO Box 636493
Cincinnati, OH 45263-6493
Phone (513) 981-5098

Other identifiers 1

IdentifierTypeStateIssuer
7100132150-RHCMedicaidKY

Other names 1

  • Mercy Health Clinic II Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100624000061 KY Part B Supplier - Clinic/Group Practice 2466592688 Receives reassigned benefits from 14 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beattyville, KY; Clay City, KY; Irvine, KY; Stanton, KY

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
Marcum Wallace Memori

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1215167432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636493",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636493",
            "telephone_number": "513-981-5098",
            "fax_number": "513-981-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MAIN ST",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403361023",
            "telephone_number": "606-723-7771",
            "fax_number": "606-723-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH CLINICS,LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARCUM AND WALLACE MEMORIAL HOSPITAL",
        "enumeration_date": "2009-07-22",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "STOCKER",
        "authorized_official_first_name": "TRENA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-779-0148",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100132150-RHC",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Health Clinic II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Health Clinic II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.