NPIMap

Organization Active NPI

Mercy Hospital Paris

  • Rural Health Clinic/Center
  • Paris, AR
National Provider Identifier
1881106243
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MERCY HOSPITAL PARIS
Practice address
303 S 5TH St
Paris, AR 72855-4501
Phone
(479) 963-2132
NPI assigned
Oct 25, 2017
Last updated
Feb 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Sherry Lynn Clouse Day
Title
VP Finance Mercy Cah
Phone
(417) 820-8439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

303 S 5TH St
Paris, AR 72855-4501

Mailing address

303 S 5TH St
Paris, AR 72855-4501
Phone (479) 963-2132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090402000673 AR Part B Supplier - Clinic/Group Practice 0244135705 Receives reassigned benefits from 156 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Paris, AR
O20171115000555 AR Part A Provider - Rural Health Clinic 0244135705 Practice locations: Paris, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881106243. Details of each certification follow.

Rural health clinic certification: CCN 048517

Legal name
MERCY HOSPITAL PARIS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 9, 2018
Last certification
Jul 19, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 1987 in AR
Enrollment address
303 S 5TH St
Paris, AR 72855-4501
Related CCNs
041300

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Eugene Alexander4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Locations

303 S 5th St
Paris, AR 72855
Phone (479) 314-3154

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jamie Wilke Individual Corporate OfficerSecretary Jul 1, 2024
Mercy Health Fort Smith Communities Organization, Fort Smith, AR Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2017 100%
Ryan Gehrig Individual Corporate OfficerPresident Nov 1, 2017
Elizabeth Maddox Individual Corporate DirectorBoard Member Jul 1, 2024
Yogya Regmi Individual W-2 Managing EmployeeVP Finance Aug 29, 2022
Michael Keith Gibbons Individual Corporate DirectorBoard Member Jul 1, 2022
Edward Melton Individual Corporate DirectorBoard Member Jul 1, 2024
Bret Cook Individual Corporate DirectorBoard Member Jul 1, 2022
Mercy Hospital Fort Smith Organization, Fort Smith, AR Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2017 100%
Martha Ullrich Individual Corporate DirectorBoard Member Jul 1, 2021
Allen Ray Individual Corporate DirectorBoard Member Jul 1, 2024
Mercy Health Organization, Chesterfield, MO Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Nov 2, 2017 100%
Carol Corley Individual Corporate DirectorBoard Member Jul 1, 2021
Judith Marie Keith Individual Corporate DirectorBoard Member Jul 1, 2021
Sherry Clouse Day Individual Corporate OfficerTreasurer Jan 1, 2021
W-2 Managing Employee Jan 1, 2021
Vicky Laird Individual Corporate DirectorBoard Member Jul 1, 2021

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 115

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 115

Practitioners & affiliated clinicians

Practitioners 57

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.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1881106243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S 5TH ST",
            "city": "PARIS",
            "state": "AR",
            "postal_code": "728554501",
            "telephone_number": "479-963-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S 5TH ST",
            "city": "PARIS",
            "state": "AR",
            "postal_code": "728554501",
            "telephone_number": "479-963-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL PARIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP FINANCE MERCY CAH",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, AR

Sources for this page

Verify at the official NPI Registry.