NPIMap

Organization Active NPI

Mercy Hospital Healdton, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Healdton, OK
National Provider Identifier
1376790147
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MERCY HOSPITAL HEALDTON, INC.
Practice address
3462 Hospital Rd
Healdton, OK 73438-6124
Phone
(580) 229-0701
NPI assigned
Aug 25, 2008
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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
Phone
(417) 820-8439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

3462 Hospital Rd
Healdton, OK 73438-6124

Mailing address

3462 Hospital Rd
Healdton, OK 73438-6124
Phone (417) 820-7133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080916000474 OK Part A Provider - Critical Access Hospital 3375610447 Practice locations: Healdton, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376790147. Details of each certification follow.

Hospital certification: CCN 37Z310

Legal name
MERCY HOSPITAL HEALDTON INC
Organization structure
CorporationNon-profit
Incorporated
Jul 31, 2008 in OK
Enrollment address
3462 Hospital Rd
Mercy Hospital Healdton Swing Bed
Healdton, OK 73438-6124
Other Hospital Practice Location

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).

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital Healdton Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Cheryl L Matejka Individual Operational/Managerial ControlSVP-Cfo Jul 1, 2021
Yogya Regmi Individual W-2 Managing Employee Aug 29, 2022
Jonathan Lofton Individual Corporate Director Jan 1, 2016
Rebecca Ann Hendricks Individual Corporate Director Aug 1, 2008
Christie Eckhardt Individual Corporate OfficerSecretary Jul 1, 2021
Mercy Health Organization, Chesterfield, MO Operational/Managerial Control Aug 1, 2008
Mercy Health Oklahoma Communities Organization, Oklahoma City, OK Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2012 100%
Darlye Voss Individual Corporate OfficerPresident Jul 1, 2021
Lindsay a Wilson Individual Corporate DirectorBoard Member Jul 1, 2022
Mercy Hospital Ardmore Inc Organization, Ardmore, OK Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2021 100%
Sherry Clouse Day Individual Corporate OfficerTreasurer Jan 1, 2021
W-2 Managing EmployeeVP of Finance-Cah Jan 1, 2021
Joy Linn Alexander Individual Corporate DirectorBoard Member Jan 1, 2016

Owners & managing parties with NPI records 5

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

Facilities with the same owner 119

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

View all 119

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1376790147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3462 HOSPITAL RD",
            "city": "HEALDTON",
            "state": "OK",
            "postal_code": "734386124",
            "telephone_number": "417-820-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3462 HOSPITAL RD",
            "city": "HEALDTON",
            "state": "OK",
            "postal_code": "734386124",
            "telephone_number": "580-229-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL HEALDTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-25",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "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",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Healdton, OK

Sources for this page

Verify at the official NPI Registry.