NPIMap

Organization Active NPI

Mercy Clinic Springfield Communities

Doing business as Mercy Clinic Convenient Care Eureka Springs

  • Family Medicine Physician
  • Eureka Springs, AR
National Provider Identifier
1679994883
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R6D08 Issued in AR
Legal business name
MERCY CLINIC SPRINGFIELD COMMUNITIES
Doing business as
Mercy Clinic Convenient Care Eureka Springs
Practice address
121 E Van Buren
Eureka Springs, AR 72632-3653
Phone
(479) 253-1758
Fax
(479) 253-7160
NPI assigned
Dec 16, 2013
Last updated
Apr 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
BJ Roberts
Title
Cfo
Phone
(417) 820-7363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R6D08 AR Primary

Addresses

Primary practice location

121 E Van Buren
Eureka Springs, AR 72632-3653

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAR

Other names 1

  • Mercy Clinic Convenient Care Eureka Springs Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090626000412 AR Part B Supplier - Clinic/Group Practice 7416865845 Receives reassigned benefits from 18 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Green Forest, AR; Omaha, AR; Eureka Springs, AR; Berryville, AR

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
Tax ID family
St Johns Physicians Cli55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 8

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1679994883",
    "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": "121 E VAN BUREN",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "726323653",
            "telephone_number": "479-253-1758",
            "fax_number": "479-253-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC SPRINGFIELD COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "BJ",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-820-7363"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R6D08",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Clinic Convenient Care Eureka Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.