NPIMap

Organization Active NPI

Mercy Hospital Watonga Inc

Doing business as Mercy Hospital Watonga

  • Critical Access Hospital
  • Watonga, OK
National Provider Identifier
1497017529
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MERCY HOSPITAL WATONGA INC
Doing business as
Mercy Hospital Watonga
Practice address
500 N Clarence Nash Blvd
Watonga, OK 73772-2845
Phone
(580) 623-7211
NPI assigned
Jun 14, 2012
Last updated
Sep 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Authorized official

Name
Sherry Clouse Day
Title
Vice President Finance
Phone
(417) 820-8439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X OK Primary

Addresses

Primary practice location

500 N Clarence Nash Blvd
Watonga, OK 73772-2845

Mailing address

500 N Clarence Nash Blvd
Watonga, OK 73772-2845

Other names 1

  • Mercy Hospital Watonga Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130618000016 OK Part A Provider - Critical Access Hospital 6305002759 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
Practice locations: Watonga, OK
O20140110000184 OK Part B Supplier - Hospital Department(S) 6305002759 Receives reassigned benefits from 66 practitioners
Practice locations: Watonga, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497017529. Details of each certification follow.

Hospital certification: CCN 371302

Legal name
MERCY HOSPITAL WATONGA INC
Doing business as
MERCY HOSPITAL WATONGA
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Mar 1, 1999
Last certification
Aug 29, 2024
Beds
25
Ownership / control type
Private (for profit)
Most recent change of ownership
Jul 1, 2012 (1 total)
Organization structure
CorporationNon-profit
Incorporated
May 3, 2012 in OK
Enrollment address
500 North Clarence Nash Blvd.
Watonga, OK 73772-2845

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).

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercy Hospital Watonga, IncCCN 371302 · All quality measures
Type
Critical Access Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

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

Locations

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

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
John M Mohart Individual Corporate Director Jul 1, 2021
Cheryl L Matejka Individual Operational/Managerial ControlSVP-Cfo Jul 1, 2021
Yogya Regmi Individual W-2 Managing Employee Aug 29, 2022
Jeffrey Peter Ciaramita Individual Corporate Director Jul 1, 2021
Christie Eckhardt Individual Corporate OfficerSecretary Jul 1, 2021
Mercy Health Organization, Chesterfield, MO Non-profit Operational/Managerial Control Jul 1, 2012 100%
Mercy Health Oklahoma Communities Organization, Oklahoma City, OK Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2014 100%
Steven Gregory Individual Corporate DirectorBoard Member Jul 1, 2021
Mercy Hospital Oklahoma City, Inc Organization, Oklahoma City, OK Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2014 100%
Krista Teply Individual Corporate DirectorBoard Member Jul 1, 2021
Sherry Clouse Day Individual Corporate OfficerTreasurer Jan 1, 2021
W-2 Managing EmployeeVP of Finance-Cah Jan 1, 2021
Bobby J Stitt Individual Corporate OfficerPresident Jul 1, 2021

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 120

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

View all 120

Practitioners & affiliated clinicians

Practitioners 73

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 73

Affiliated clinicians 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1497017529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N CLARENCE NASH BLVD",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737722845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N CLARENCE NASH BLVD",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737722845",
            "telephone_number": "580-623-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL WATONGA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Hospital Watonga",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Hospital Watonga",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watonga, OK

Sources for this page

Verify at the official NPI Registry.