Mercy Clinic Springfield Communities

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E1025 Issued in AR

Legal business name

MERCY CLINIC SPRINGFIELD COMMUNITIES

Doing business as

Mercy Clinic-Holiday Island

Practice address

1 Park Dr
Suite C
Holiday Island, AR 72631-9216

Phone

(479) 363-9174

Fax

(479) 363-9175

NPI assigned

Jun 23, 2006

Last updated

Oct 10, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Stuart G. Stangeland

Title

Senior Vice President/Coo

Phone

(417) 820-6556

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MERCY CLINIC-HOLIDAY ISLAND Doing business as

Locations

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1538195508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK DR",
            "address_2": "SUITE C",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319216",
            "telephone_number": "479-363-9174",
            "fax_number": "479-363-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "STANGELAND",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "417-820-6556",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141392002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY CLINIC-HOLIDAY ISLAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Johnson, RPH
• Kristin Jones, COTA
• Lindsey Jones, COTA
• Andy Langston, OD, PA
• Danyal Loftin, PTA
• Reilly Nichols
• Peachtree Village at Holiday Island
• Jeffery L. Price, PHARM.D.
• Ptworks,P.a.
• Ana Rebeca Rodriguez, LPC

• Family Medicine Physician in Holiday Island, AR
• Providers in Holiday Island, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.