Mercy Hospital Oklahoma City, Inc.
Organization Active NPI Community Based Hospice Care Agency · Oklahoma City, OK
NPI 1487748646 · NPPES record last updated Jul 20, 2022
Key facts
- NPI
- 1487748646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 4004 (OK)
- Legal business name
- MERCY HOSPITAL OKLAHOMA CITY, INC.
- Practice address
- 4401 W Memorial Rd Ste 116
Oklahoma City, OK 73134-1722 - Phone
- (405) 486-8600
- Fax
- (405) 752-3918
- NPI assigned
- Oct 3, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- MERCY HOSPITAL OKLAHOMA CITY, INC.
Authorized official
- Name
- Christopher Haney
- Title
- Vice President Finance
- Phone
- (405) 936-5649
Owners & managing parties with NPI records 2
-
Jeffrey Peter Ciaramita, M.D.
-
John M Mohart, M.D.
Owned or controlled facilities with NPI records 10
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 6
Facilities with the same owner 118
Practitioners 37
-
Mazen S Abu-Fadel, M.D.
-
Syed Haider Ali, M.D.
-
Mark Anderson, M.D.
-
Afsaneh Faramarzi, APRN-CNP
-
Brian S Hailey, MD
-
Michael Koehler, MD
-
Nicole Marie Massie, PA-C
-
Derek L Norman, MD
-
Sarah Lynn Oberste, D.O
-
Matthew Orgel, MD
-
Michael Lynn Partin, M.D.
-
Branislav Schifferdecker, M.D.
-
Brook D Scott, M.D.
-
Shujahat H. Shah, M.D.
-
Christopher Michael Shy, PA-C
-
Bryan Lee Van Zandt, M.D.
-
Gregory B Vanzant, D.O.
-
Benoy Varghese, MD
-
Imran Saleem Virk, M.D.
-
Soni J Zacharias, MD
Affiliated clinicians 40
-
David E Abernethy, M.D.
-
Nicholas Anastas, DO
-
Lydia Rene Ballard, M.D.
-
Cory Bright, MD
-
Jimmy Bui, D.O.
-
Tina Bui, MD
-
Erica D Dearman, DO
-
Jane Detrich, DO
-
Ashley Ford, D.O.
-
Chris Gasbarra, DO
-
Majed Gharfeh, M.D.
-
Robert Hamilton, MD
-
Awaad Khan, M.D.
-
Carla Kurkjian, M.D.
-
Gary Monroe Lawrence, M.D.
-
Bahar Malakouti, M.D.
-
Jacklyn Papa, DO
-
Vivian Pham, DO
-
Paul L. Plusquellec Jr., M.D.
-
Karen M Ross, MD
Medicare Care Compare: Hospice
- Listed as
- Mercy Hospice
- Ownership
- Non-Profit
- Certified
- Mar 20, 1990
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Hospice certification: CCN 371509
- Legal name
- MERCY HOSPITAL OKLAHOMA CITY, INC
- Doing business as
- MERCY HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 20, 1990
- Last certification
- Oct 6, 2020
- Ownership / control type
- Non-Profit - Private
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 12, 1974 in OK
- Enrollment address
- 4401 W Memorial Rd Ste 116
Mercy Hospice
Oklahoma City, OK 73134-1787
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Jamie Wilke |
Corporate Officer |
Jul 1, 2024 | |
| Shannon Sock |
Corporate Director |
Jul 1, 2021 | |
| John M Mohart |
Corporate Director |
Jul 1, 2021 | |
| Jennifer Cohen |
W-2 Managing Employee |
Jun 29, 2025 | |
| Jeffrey Peter Ciaramita |
Corporate Director |
Jul 1, 2021 | |
| Mercy Health |
5% Or Greater Indirect Ownership Interest | Oct 1, 1986 | 100% |
| Mercy Health Oklahoma Communities |
5% Or Greater Direct Ownership Interest | Aug 10, 2012 | 100% |
| Christopher F Hahne |
Corporate Officer |
Oct 1, 2021 | |
| Brian Day |
Corporate Officer |
Jun 25, 2025 | |
| Brian Bennett Geister |
Corporate Officer |
May 28, 2024 |
All facility ownership & control disclosures 10
| Facility | Type | Role | Since |
|---|---|---|---|
| Mercy Hospital Logan County |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2014 |
| Mercy Hospital Logan County |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2014 |
| Mercy Rehabilitation Hospital Oklahoma City |
Hospital | 5% Or Greater Direct Ownership Interest (49.5%) | Dec 22, 2010 |
| Mercy Hospital Watonga |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2014 |
| Mercy Hospital Watonga Inc |
Hospital | 5% Or Greater Direct Ownership Interest | Jul 1, 2014 |
| Mercy Hospital Kingfisher, Inc |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2013 |
| Mercy Hospital Kingfisher, Inc |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2013 |
| Mercy Rehabilitation Hospital Oklahoma City South |
Hospital | 5% Or Greater Indirect Ownership Interest (49.5%) | Mar 1, 2021 |
| Mercy Hospital Logan County -Guthrie Division Primary Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2014 |
| Mercy Hospital Logan County-Crescent Primary Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2014 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080916000364 | OK | Part a Provider - Hospice | 8022920982 | Practice locations: Oklahoma City, OK |
National Provider Directory
- Tax ID family
- Mercy Health Canadian C
- Part of
- Mercy Health Canadian C
Locations
4401 W Memorial Rd
Ste 143
Oklahoma City, OK 73134
Phone (405) 486-8600
4401 W Memorial Rd
Ste 116
Oklahoma City, OK 73134
Phone (405) 486-8600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 4004 | OK | Yes |
Addresses
Primary practice location
4401 W Memorial Rd Ste 116
Oklahoma City, OK 73134-1722
Mailing address
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000371509-001 | Other | OK | BC/BS # - HOSPICE |
Other names
- Mercy Hospice
Other providers in Oklahoma City, OK
- Mercy Hospital Oklahoma City, Inc
- Mercy Hospital Oklahoma City, Inc
- Mercy Hospital Oklahoma City, Inc.
- Mercy Hospital Oklahoma City, Inc.
- Mercy Hospital Oklahoma City, Inc.
- Mercy Hospital Oklahoma City, Inc.
- Mercy Insulin Pump Supply Incorporated
- Mercy Pharmacy Services LLC
- Mercy Pharmacy Services, LLC
- Mercy Pharmacy Services, LLC
All providers in Oklahoma City, OK · Community Based Hospice Care Agency in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.