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Mercy Medical Health Center

Organization Active NPI Federally Qualified Health Center (FQHC) · Ruston, LA

NPI 1346907086 · NPPES record last updated Jun 26, 2025

Key facts

NPI
1346907086
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
MERCY MEDICAL HEALTH CENTER
Practice address
900 S Vienna St
Ruston, LA 71270-5830
Phone
(318) 251-0334
NPI assigned
Nov 17, 2021
Organization subpart
Yes
Parent organization (as reported)
MERCY MEDICAL HEALTH CENTER

Authorized official

Name
Kimberly G. Brunson, APRN
Title
Ceo
Phone
(318) 259-1100

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.

Owners & managing parties with NPI records 3

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

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 5

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

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

Federally qualified health center certification: CCN 951002

Legal name
MERCY MEDICAL HEALTH CENTER
Doing business as
MERCY DENTAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 21, 2025
Last certification
Aug 21, 2025
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
900 S Vienna St
Ruston, LA 71270-5830

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Mercy Medical Health Center
Organization · Ruston, LA
Non-profit 		Other Jan 1, 2022 100%
Kimberly Brunson
Individual 		5% Or Greater Direct Ownership Interest
Owner		 Jan 22, 2018
W-2 Managing Employee
Ceo		 Jan 22, 2018
Operational/Managerial Control
Ceo		 Jan 22, 2018
Rennata Becks
Individual 		W-2 Managing Employee
Coo		 May 1, 2017
Operational/Managerial Control
Coo		 May 1, 2017

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Medical Health Center
Jonesboro, LA · CCN 191007		 Federally qualified health center Operational/Managerial Control (100%) Sep 5, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170614000398 LA Part B Supplier - Clinic/Group Practice 1557639655 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arcadia, LA; Jonesboro, LA; Ruston, LA
O20251114001419 LA Part a Provider - Federally Qualified Health Center (FQHC) 1557639655 Practice locations: Ruston, LA

National Provider Directory

Tax ID family
Mercy Medical LLC (6 organizations share this tax ID)
Part of
Mercy Medical LLC

Locations

600 Factory Outlet Dr
Ste 12
Arcadia, LA 71001
Phone (318) 263-4701

4633 Quitman Hwy
Hodge, LA 71247
Phone (318) 259-1100

4629 Quitman Hwy
Hodge, LA 71247
Phone (318) 259-1100

244 Bond St
Jonesboro, LA 71251
Phone (318) 259-1100

900 S Vienna St
Ruston, LA 71270
Phone (318) 251-0334

2120 Bert Kouns Industrial Loop
Ste A
Shreveport, LA 71118
Phone (318) 688-3350

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

900 S Vienna St
Ruston, LA 71270-5830

Mailing address

PO Box 70
Hodge, LA 71247-0070
Phone (318) 259-1100

Other names

  • Mercy Dental Doing business as

Other providers in Ruston, LA

All providers in Ruston, LA · Federally Qualified Health Center (FQHC) in Louisiana

Sources for this page

Verify at the official NPI Registry.