Mercy Clinic Joplin LLC

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

Legal business name

MERCY CLINIC JOPLIN LLC

Practice address

214 Carter St
Berryville, AR 72616-4303

Phone

(870) 423-5203

Fax

(870) 423-5178

NPI assigned

Dec 30, 2014

Last updated

Dec 30, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tracy A Godfrey, MD

Title

Division Vice President

Phone

(417) 627-8962

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Columbus, KS
  • NPI 1043547474

  0547300196

  Same PAC ID
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817

  0547300196

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

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

• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Columbus, KS
  • NPI 1043547474

  O20150122002120

  Same enrollment
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817

  O20150122002120

  Same enrollment

Practitioners 1

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.

• Joshua Ryan Sweet, P.A.

  • Physician Assistant
  • Joplin, MO
  • NPI 1174913123

  AR

  Medicare reassignment

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1356739288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 MCCLELLAND BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041637",
            "telephone_number": "417-627-8962",
            "fax_number": "417-627-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CARTER ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164303",
            "telephone_number": "870-423-5203",
            "fax_number": "870-423-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC JOPLIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIVISION VICE PRESIDENT",
        "authorized_official_telephone_number": "417-627-8962",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McNeal Chiropractic Ctr, Inc
• Charles William McNeal, D.C.
• Ramona Lee McNeal
• Joanna McWilliam
• Laura Susan Menees, LCSW
• Mercy Clinic Springfield Communities (Mercy Clinic General Surgery-Berryville)
• Mercy Clinic Springfield Communities (Mercy Clinic Ear, Nose & Throat-Berryville)
• Mercy Clinic Springfield Communities
• Mercy Clinic Springfield Communities (Mercy Radiology Berryville)
• Mercy Clinic Springfield Communities (Mercy Clinic-Family Medicine Berryville)

• Sleep Medicine (Internal Medicine) Physician in Berryville, AR
• Providers in Berryville, AR by specialty
• Sleep Medicine (Internal Medicine) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.