NPIMap

Organization Active NPI

Cleveland Clinic Mercy Hospital

Doing business as Mercy OB GYN Services and Mercy Ambulatory Care Clinic Internal Medi

  • Multi-Specialty Clinic/Center
  • Canton, OH
National Provider Identifier
1376559799
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CLEVELAND CLINIC MERCY HOSPITAL
Doing business as
Mercy OB GYN Services and Mercy Ambulatory Care Clinic Internal Medi
Practice address
1320 Mercy Dr NW
Canton, OH 44708-2614
Phone
(330) 489-1066
Fax
(330) 471-5938
NPI assigned
Jul 31, 2006
Last updated
Apr 16, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Authorized official

Name
Michael C Holt
Title
Director of Finance
Phone
(330) 489-1268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1320 Mercy Dr NW
Canton, OH 44708-2614

Mailing address

1320 Mercy Dr NW
Canton, OH 44708-2614
Phone (330) 471-5930

Other identifiers 1

IdentifierTypeStateIssuer
2157320MedicaidOH

Other names 1

  • Mercy OB GYN Services and Mercy Ambulatory Care Clinic Internal Medi Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224001287 OH Part B Supplier - Clinic/Group Practice 0547156796 Receives reassigned benefits from 286 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Massillon, OH; Uniontown, OH; North Canton, OH; New Philadelphia, OH; Louisville, OH; Carrolton, OH; Canton, OH; Alliance, OH

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Part of
Ambulatory Care Clinic

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

1031 W High Ave
New Philadelphia, OH 44663
Phone (330) 365-5100

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1376559799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-471-5930",
            "fax_number": "330-471-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1066",
            "fax_number": "330-471-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND CLINIC MERCY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY MEDICAL CENTER, INC.",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "330-489-1268"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2157320",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy OB GYN Services and Mercy Ambulatory Care Clinic Internal Medi",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy OB GYN Services and Mercy Ambulatory Care Clinic Internal Medi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.