NPIMap

Organization Active NPI

Mercy Health Clinics, LLC

Doing business as Mercy Health Powell County Primary Care

  • Rural Health Clinic/Center
  • Clay City, KY
National Provider Identifier
1386921948
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
900249 Issued in KY
Legal business name
MERCY HEALTH CLINICS, LLC
Doing business as
Mercy Health Powell County Primary Care
Practice address
749 Irvine Rd
Clay City, KY 40312-9732
Phone
(606) 663-2153
Fax
(606) 663-7966
NPI assigned
Nov 10, 2011
Last updated
Mar 11, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MARCUM & WALLACE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Cassie Lowe
Title
System Director, Payer Delegation &
Phone
(513) 952-5210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 900249 KY Primary

Addresses

Primary practice location

749 Irvine Rd
Clay City, KY 40312-9732

Mailing address

4600 McAuley PL Ste 600
Blue Ash, OH 45242-4778
Phone (513) 981-5098

Other identifiers 1

IdentifierTypeStateIssuer
7100233000MedicaidKY

Other names 1

  • Mercy Health Powell County Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100624000061 KY Part B Supplier - Clinic/Group Practice 2466592688 Receives reassigned benefits from 14 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beattyville, KY; Clay City, KY; Irvine, KY; Stanton, KY
O20120924000273 KY Part A Provider - Rural Health Clinic 2466592688 Practice locations: Clay City, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386921948. Details of each certification follow.

Rural health clinic certification: CCN 183475

Legal name
MERCY HEALTH CLINICS LLC
Doing business as
MERCY HEALTH - POWELL COUNTY PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 5, 2012
Last certification
Jul 30, 2019
Ownership / control type
2B
Organization structure
LLCNon-profit
Incorporated
Aug 27, 2009 in KY
Enrollment address
749 Irvine Rd
Clay City, KY 40312-9732
Related CCNs
181301

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2033408Mercy Health - Powell County Primary Care749 Irvine Road, Clay City, KY 40312Certificate of waiverNov 30, 2027

National Provider Directory

National Provider Directory
Part of
Marcum Wallace Memori

Member of 2

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

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Scotty Dwayne Combs Individual Corporate DirectorBoard Member Jan 1, 2024
Justin Dixon Individual Corporate DirectorBoard Member Mar 1, 2015
Trena Lynn Stocker Individual Corporate OfficerPresident Apr 28, 2019
Corporate DirectorBoard Member Apr 28, 2019
W-2 Managing EmployeePresident Apr 28, 2019
Michael J Yungmann Individual Corporate DirectorBoard Member Jan 9, 2017
Maher Kassis Individual Corporate DirectorBoard Member Mar 1, 2014
Rondle Simpson Individual Corporate DirectorBoard Member Jan 1, 2026
Joe Crawford Individual Corporate DirectorBoard Member Jan 1, 2022
Patricia M Rice Individual Corporate DirectorBoard Member Sep 1, 2012
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2018 100%
John Starcher Individual Operational/Managerial ControlCho Admin Mar 16, 2016
Ethan Witt Individual Corporate DirectorBoard Member Jan 1, 2022
Kayla Carroll Individual Corporate DirectorBoard Member Jan 1, 2024
Mercy Health-Marcum & Wallace Hospital LLC Organization, Irvine, KY Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2012 100%
Ethan Moore Individual Corporate DirectorBoard Member Jan 1, 2024
Regina Robertson Individual Corporate DirectorBoard Member Jan 1, 2023
Mercy Health-Lourdes Hospital LLC Organization, Paducah, KY Non-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2012 100%
Diann Meadows Individual Corporate DirectorBoard Member Jan 1, 2026
Marty Snowden Individual Corporate DirectorBoard Member Jan 1, 2024
Andrea Springer Individual Corporate DirectorBoard Member Jan 1, 2025
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Oct 7, 2017
Sandy Dunahoo Individual Corporate DirectorBoard Member Jan 1, 2024

Owners & managing parties with NPI records 9

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

Facilities with the same owner 97

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

View all 97

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.

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1386921948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MCAULEY PL STE 600",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452424778",
            "telephone_number": "513-981-5098",
            "fax_number": "513-981-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 IRVINE RD",
            "city": "CLAY CITY",
            "state": "KY",
            "postal_code": "403129732",
            "telephone_number": "606-663-2153",
            "fax_number": "606-663-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH CLINICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARCUM & WALLACE MEMORIAL HOSPITAL",
        "enumeration_date": "2011-11-10",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR, PAYER DELEGATION &",
        "authorized_official_telephone_number": "513-952-5210"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100233000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Health Powell County Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clay City, KY

Sources for this page

Verify at the official NPI Registry.