Mercy Health Canadian County Ambulatory Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0060 Issued in OK

Legal business name

MERCY HEALTH CANADIAN COUNTY AMBULATORY SURGICAL CENTER LLC

Practice address

520 S Mustang Rd
Suite S
Yukon, OK 73099-6737

Phone

(405) 936-5900

Fax

(405) 577-2032

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Diana L. Smalley

Title

President & Ceo

Phone

(405) 752-3756

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1639196355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE #141; ATTN: BECKY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-936-5811",
            "fax_number": "405-936-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S MUSTANG RD",
            "address_2": "SUITE S",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996737",
            "telephone_number": "405-936-5900",
            "fax_number": "405-577-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH CANADIAN COUNTY AMBULATORY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "SMALLEY",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "405-752-3756"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OK",
            "license": "0060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS #",
            "identifier": "000371045-001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Meier
• Hailey Makayla Melton
• Rhonda G Mercado
• Andrea Mercer, LPC CANDIDATE
• Kyra Marcy Kathleen Merchen
• Mercy Health Services Inc.
• Mercy Hospital Oklahoma City, Inc
• Mercy Pharmacy Services, LLC
• Daniel Patrick Mesa
• Mark A Mesikep, DDS

• Ambulatory Surgical Clinic/Center in Yukon, OK
• Providers in Yukon, OK by specialty
• Ambulatory Surgical Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.