NPIMap

Organization Active NPI

Mercy Health Physicians North Specialty Care LLC

  • Customized Equipment (DME)
  • Oregon, OH
National Provider Identifier
1942962386
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
MERCY HEALTH PHYSICIANS NORTH SPECIALTY CARE LLC
Practice address
1050 Isaac Streets Dr Ste 122
Oregon, OH 43616-3243
Phone
(419) 693-4171
Fax
(419) 693-6863
NPI assigned
Oct 13, 2021
Last updated
Oct 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Wilbur Gay
Title
Cfo
Phone
(864) 605-3762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

1050 Isaac Streets Dr Ste 122
Oregon, OH 43616-3243

Mailing address

PO Box 631336
Cincinnati, OH 45263-1336
Phone (888) 696-3541

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220127000892 OH DME Supplier - Multi-Specialty - Physician 1951707884 Practice locations: Oregon, OH

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Mercy Health Physicians North Specialty Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1050 Isaac Streets Dr
Ste 122
Oregon, OH 43616
Phone (419) 693-4171

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1942962386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631336",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631336",
            "telephone_number": "888-696-3541",
            "fax_number": "513-952-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 ISAAC STREETS DR STE 122",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163243",
            "telephone_number": "419-693-4171",
            "fax_number": "419-693-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH PHYSICIANS NORTH SPECIALTY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-605-3762"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.