NPIMap

Organization Active NPI

Mercy Health-Marcum & Wallace Hospital LLC

  • Critical Access Hospital
  • Irvine, KY
National Provider Identifier
1285632109
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MERCY HEALTH-MARCUM & WALLACE HOSPITAL LLC
Practice address
60 Mercy CT
Irvine, KY 40336-1331
Phone
(606) 723-2115
Fax
(606) 723-2951
NPI assigned
Jul 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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
Critical Access Hospital 282NC0060X KY Primary

Addresses

Primary practice location

60 Mercy CT
Irvine, KY 40336-1331

Mailing address

60 Mercy CT
Irvine, KY 40336-1331
Phone (606) 723-2115

Other identifiers 1

IdentifierTypeStateIssuer
01002526MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Bassem Adie MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285632109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MERCY CT",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403361331",
            "telephone_number": "606-723-2115",
            "fax_number": "606-723-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MERCY CT",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403361331",
            "telephone_number": "606-723-2115",
            "fax_number": "606-723-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH-MARCUM & WALLACE HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2022-07-21",
        "certification_date": "2022-01-26",
        "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": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01002526",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; 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.