Mercy Medical Center, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

141133 Issued in OR

Legal business name

MERCY MEDICAL CENTER, INC.

Practice address

2675 NW Edenbower Blvd
Roseburg, OR 97471-6201

Phone

(541) 677-2384

Fax

(541) 677-2498

NPI assigned

Jun 18, 2006

Last updated

Jul 17, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

MERCY MEDICAL CENTER, INC.As reported in NPPES

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

Authorized official

Name

Kelly C. Morgan

Title

Ceo/President

Phone

(541) 677-2466

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mercy Medical Center Home Health Service Other name

Part of

Mercy Medical Center

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1609811181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716201",
            "telephone_number": "541-677-2384",
            "fax_number": "541-677-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716201",
            "telephone_number": "541-677-2384",
            "fax_number": "541-677-2498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 NW Stewart Pkwy",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974715659",
            "country_code": "US",
            "telephone_number": "541-677-2458",
            "fax_number": "541-677-1554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY MEDICAL CENTER, INC.",
        "enumeration_date": "2006-06-18",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "541-677-2466"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OR",
            "license": "141133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136770",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Medical Center Home Health Service",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mercy Medical Center Home Health Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brittany Menefee, LMT
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• Meredith Krugel LCSW PC
• Thomas P Metzger

• Home Health Agency in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Home Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.