NPIMap

Organization Active NPI

Mercy Hospital Berryville

  • Medicare Defined Swing Bed Hospital Unit
  • Berryville, AR
National Provider Identifier
1487692240
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
AR4317 Issued in AR
Legal business name
MERCY HOSPITAL BERRYVILLE
Doing business as
Mercy Hospital Berryville
Practice address
214 Carter St
Berryville, AR 72616-4303
Phone
(870) 423-3355
Fax
(870) 423-5268
NPI assigned
Jun 3, 2006
Last updated
Sep 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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 AR4317 AR Primary

Addresses

Primary practice location

214 Carter St
Berryville, AR 72616-4303

Mailing address

214 Carter St
Berryville, AR 72616-4303
Phone (870) 423-3355

Other names 1

  • Mercy Hospital Berryville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061215000475 AR Part A Provider - Critical Access Hospital 9032022769 Practice locations: Berryville, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487692240. Details of each certification follow.

Hospital certification: CCN 04Z329

Legal name
MERCY HOSPITAL BERRYVILLE
Doing business as
MERCY HOSPITAL BERRYVILLE
Organization structure
CorporationNon-profit
Incorporated
Dec 31, 1996 in AR
Enrollment address
214 Carter St
Berryville, AR 72616-4303
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Kent L Croswell5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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 16

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

NameRoleSinceShare
Cabrini Koelsch Individual Corporate Officer Jul 1, 2018
Charles R. Horton Individual Corporate DirectorBoard Member Jul 1, 2020
Scott Snow Cooper Individual Corporate DirectorBoard Member Jul 1, 2022
Jamie Wilke Individual Corporate OfficerSecretary Jul 1, 2024
Mercy Health Northwest Arkansas Communities Organization, Rogers, AR Corporation, For-profit, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 1, 2018 100%
Jennifer Cohen Individual W-2 Managing EmployeeDirector May 27, 2025
Jason Wildman Individual Corporate DirectorBoard Member Jul 1, 2022
Richard L Taylor Individual Corporate Director Jul 1, 2017
Clifford Dean Lee Individual Corporate DirectorBoard Member Jul 1, 2022
Linda Tamayo Individual Corporate DirectorBoard Member Jul 1, 2022
Mercy Health Organization, Chesterfield, MO Created for acquisition, Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Nov 8, 2007 100%
David Teigen Individual Corporate DirectorBoard Member Jun 1, 2025
Troy Johnson Individual Corporate DirectorBoard Member Jul 1, 2020
Melissa Casey Individual Corporate DirectorBoard Member Jul 1, 2022
Sherry Clouse Day Individual Corporate OfficerTreasurer Jan 1, 2021
W-2 Managing Employee Jan 1, 2021
Brian Day Individual Corporate OfficerSenior Vice President Jun 1, 2025

Owners & managing parties with NPI records 8

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

Facilities with the same owner 116

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

View all 116

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 3

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1487692240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CARTER ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164303",
            "telephone_number": "870-423-3355",
            "fax_number": "870-423-5268"
        },
        {
            "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": "870-423-3355",
            "fax_number": "870-423-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL BERRYVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "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": "AR",
            "license": "AR4317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Hospital Berryville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Hospital Berryville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berryville, AR

Sources for this page

Verify at the official NPI Registry.