NPIMap

Organization Active NPI

Mercy Health-Lourdes Hospital LLC

Doing business as Mercy Health Hospice Metropolis

  • Community Based Hospice Care Agency
  • Metropolis, IL
National Provider Identifier
1669452033
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2001139 Issued in IL
Legal business name
MERCY HEALTH-LOURDES HOSPITAL LLC
Doing business as
Mercy Health Hospice Metropolis
Practice address
704 E 5TH St Ste 5
Metropolis, IL 62960
Phone
(618) 524-3647
Fax
(270) 444-2379
NPI assigned
Jan 20, 2006
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Kimberly Ralston
Title
System Director Payor Admin
Phone
(419) 996-5119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2001139 IL Primary

Addresses

Primary practice location

704 E 5TH St Ste 5
Metropolis, IL 62960

Mailing address

225 Medical Center Dr Ste 203
Paducah, KY 42003-7907
Phone (618) 524-3647

Other names 1

  • Mercy Health Hospice Metropolis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209001113 KY Part B Supplier - Clinic/Group Practice 7315831666 Receives reassigned benefits from 14 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Benton, KY

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

616 Market St
Metropolis, IL 62960
Phone (618) 524-3647

704 E 5th St
Ste 5
Metropolis, IL 62960
Phone (618) 524-3647

225 Medical Center Dr
Ste 203
Paducah, KY 42003
Phone (270) 415-6100

911 Joe Clifton Dr
Paducah, KY 42001
Phone (270) 415-3886

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Apr 23, 2024 Change of OwnershipThis provider was the seller Mercy Health Hospice by CompassusCCN 141548, IL, NPI 1306664255

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1669452033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR STE 203",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037907",
            "telephone_number": "618-524-3647",
            "fax_number": "270-444-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 E 5TH ST STE 5",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "62960",
            "telephone_number": "618-524-3647",
            "fax_number": "270-444-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH-LOURDES HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR PAYOR ADMIN",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "2001139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Health Hospice Metropolis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Health Hospice Metropolis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metropolis, IL

Sources for this page

Verify at the official NPI Registry.