Mercy Regional Health Systems

Primary specialty

AmbulanceTaxonomy code 341600000X

License

6567 Issued in IL

Legal business name

MERCY REGIONAL HEALTH SYSTEMS

Doing business as

Mercy Regional Emergency Health Services

Practice address

205 Bailey LN
Benton, IL 62812-1921

Phone

(618) 439-9400

Fax

(618) 439-7138

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Clayton Wheeler Hobbs, PARAMEDIC

Title

Chief Executive Officer

Phone

(618) 439-9400

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Mercy Regional Emergency Health Services Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1518997469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BAILEY LN",
            "address_2": "P O BOX 337",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121921",
            "telephone_number": "618-439-9400",
            "fax_number": "618-439-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BAILEY LN",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121921",
            "telephone_number": "618-439-9400",
            "fax_number": "618-439-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY REGIONAL HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HOBBS",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "WHEELER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "618-439-9400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "6567",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "6567",
            "primary": false
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "344600000X",
            "taxonomy_group": "",
            "desc": "Taxi",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0002529972",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Regional Emergency Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulance in Benton, IL
• Providers in Benton, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.