NPIMap

Organization Active NPI

Mercy Health Northwest Arkansas Communities

  • Otolaryngology Physician
  • Rogers, AR
National Provider Identifier
1508167677
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES
Practice address
5204 W Redbud St
Rogers, AR 72758-8936
Phone
(479) 636-0110
Fax
(479) 631-0491
NPI assigned
Nov 5, 2010
Last updated
Apr 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Greta Wilcher
Title
Cfo
Phone
(479) 314-6104

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary
Audiologist 231H00000X

Addresses

Primary practice location

5204 W Redbud St
Rogers, AR 72758-8936

Mailing address

5204 W Redbud St
Rogers, AR 72758-8936
Phone (479) 636-0110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110302000405 AR Part B Supplier - Clinic/Group Practice 0648177873 Receives reassigned benefits from 14 practitioners
Practice locations: Rogers, AR

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Patricia Duckworth NP6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Hospital Northwest ArkansasRogers, AR, CCN 040010 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 9, 1995
Mercy Hospital BerryvilleBerryville, AR, CCN 041329 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 2, 2018
Mercy Hospital BerryvilleBerryville, AR, CCN 04Z329 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jul 1, 2018
Mercy Rehabilitation Hospital Northwest ArkansasRogers, AR, CCN 043036 Hospital 5% Or Greater Indirect Ownership Interest (49.5%) Sep 28, 2023
Mercy Home HealthRogers, AR, CCN 047149 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Dec 23, 2011

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1508167677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588936",
            "telephone_number": "479-636-0110",
            "fax_number": "479-631-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588936",
            "telephone_number": "479-636-0110",
            "fax_number": "479-631-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "WILCHER",
        "authorized_official_first_name": "GRETA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "479-314-6104"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.