NPIMap

Organization Active NPI

Mercy Medical Center Inc.

  • Clinical Social Worker
  • Roseburg, OR
National Provider Identifier
1922108679
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MERCY MEDICAL CENTER INC.
Practice address
2459 NW Stewart Pkwy
Roseburg, OR 97471-1596
Phone
(541) 677-4836
Fax
(541) 677-6568
NPI assigned
Sep 23, 2006
Last updated
Sep 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Authorized official

Name
John S. Kasberger
Title
Vice President Cfo
Phone
(541) 677-2458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2459 NW Stewart Pkwy
Roseburg, OR 97471-1596

Mailing address

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone (541) 677-4836

Other names 1

  • Mercy Medical Center Employee Assistance ServiceWorkLife Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

2459 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 677-2102

Practitioners & affiliated clinicians

Practitioners 3

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": "1158969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1922108679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711281",
            "telephone_number": "541-677-4836",
            "fax_number": "541-677-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2459 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711596",
            "telephone_number": "541-677-4836",
            "fax_number": "541-677-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-23",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "KASBERGER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "VICE PRESIDENT CFO",
        "authorized_official_telephone_number": "541-677-2458"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Medical Center Employee Assistance ServiceWorkLife Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.