NPIMap

Organization Active NPI

Mercy Hospital Carthage

Doing business as Mercy Hospital Carthage - Pediatrics

  • Rural Health Clinic/Center
  • Carthage, MO
National Provider Identifier
1285904342
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MERCY HOSPITAL CARTHAGE
Doing business as
Mercy Hospital Carthage - Pediatrics
Practice address
1615 Hazel Ave
Carthage, MO 64836-3020
Phone
(417) 237-0983
NPI assigned
Jan 6, 2012
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Sherry Lynn Clouse Day
Title
VP Finance Mercy Cah
Phone
(417) 820-8439

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1615 Hazel Ave
Carthage, MO 64836-3020

Mailing address

1615 Hazel Ave
Carthage, MO 64836-3020
Phone (417) 237-0983

Other names 1

  • MERCY HOSPITAL CARTHAGE - PEDIATRICS Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120225000071 MO Part B Supplier - Clinic/Group Practice 8426225251 Receives reassigned benefits from 134 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carthage, MO
O20121009000064 MO Part A Provider - Rural Health Clinic 8426225251 Practice locations: Carthage, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285904342. Details of each certification follow.

Rural health clinic certification: CCN 268689

Legal name
MERCY HOSPITAL CARTHAGE
Doing business as
MERCY HOSPITAL CARTHAGE-PEDIATRICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 12, 2013
Last certification
Sep 15, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1615 Hazel Ave
Carthage, MO 64836-3020
Related CCNs
261338

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

Other NPIs with the same Medicare PAC ID 3

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
Tax ID family
Mercy Hospital Carthage7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jamie Wilke Individual Corporate OfficerSecretary Jul 1, 2024
Mercy Health Southwest Missouri Kansas Communities Organization, Joplin, MO Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2012 100%
Shannon Sock Individual Corporate Director Jul 1, 2021
John M Mohart Individual Corporate Director Jul 1, 2021
Jeremy S Drinkwitz Individual Corporate OfficerPresident Sep 1, 2025
Jeffrey Peter Ciaramita Individual Corporate Director Jul 1, 2021
Belinda Farmer Individual Corporate DirectorBoard Member Sep 1, 2025
Stacie Farnam Individual W-2 Managing Employee Jan 1, 2021
Mercy Health Organization, Chesterfield, MO Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Aug 1, 2012 100%
Sherry Clouse Day Individual Corporate OfficerTreasurer Aug 14, 2020
Brian Day Individual Corporate OfficerSenior Vice President Sep 1, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 114

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

View all 114

Practitioners & affiliated clinicians

Practitioners 8

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": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1285904342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 HAZEL AVE",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648363020",
            "telephone_number": "417-237-0983",
            "fax_number": "417-237-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HAZEL AVE",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648363020",
            "telephone_number": "417-237-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL CARTHAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP FINANCE MERCY CAH",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY HOSPITAL CARTHAGE - PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carthage, MO

Sources for this page

Verify at the official NPI Registry.