NPIMap

Organization Active NPI

Mercy Hospital Perry

  • Medicare Defined Swing Bed Hospital Unit
  • Perryville, MO
National Provider Identifier
1952087546
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MERCY HOSPITAL PERRY
Practice address
434 N West St
Perryville, MO 63775-1359
Phone
(573) 541-2530
Fax
(573) 517-0347
NPI assigned
Jun 27, 2023
Last updated
Jun 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

434 N West St
Perryville, MO 63775-1359

Mailing address

434 N West St
Perryville, MO 63775-1359
Phone (573) 541-2530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231102002823 MO Part A Provider - Critical Access Hospital 1153777826 Practice locations: Perryville, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952087546. Details of each certification follow.

Hospital certification: CCN 26Z311

Legal name
MERCY HOSPITAL PERRY
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 2023 in MO
Enrollment address
434 N West St
Perryville, MO 63775-1359
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital Perry2 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.

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Gary Schumer Individual Corporate DirectorBoard Member Oct 1, 2023
Daniel S Eckenfels Individual Corporate DirectorBoard Member Oct 1, 2023
Gregory Unger Individual Corporate DirectorBoard Member Oct 1, 2023
Robin Simms Individual Corporate DirectorBoard Member Oct 1, 2023
Sandeep C Rao Individual Corporate DirectorBoard Member Oct 1, 2023
Christopher Wibbenmeyer Individual Corporate OfficerPresident Oct 1, 2023
W-2 Managing EmployeeAdministrator Oct 1, 2023
Matthew D Gaeta Individual Corporate DirectorBoard Member Oct 1, 2023
Cheryl L Matejka Individual Operational/Managerial ControlSVP-Cfo Oct 1, 2023
Linda Buerck Individual Corporate DirectorBoard Member Oct 1, 2023
Christie Eckhardt Individual Corporate OfficerSecretary Oct 1, 2023
Stacie Farnam Individual W-2 Managing Employee Oct 1, 2023
Mercy Health Organization, Chesterfield, MO Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2023 100%
Craig Hayden Individual Corporate DirectorChairman Oct 1, 2023
Ryan E Johnston Individual Corporate DirectorBoard Member Oct 1, 2023
Kay Taylor Individual Corporate DirectorBoard Member Oct 1, 2023
Mercy Health East Communities Organization, Saint Louis, MO Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2023 100%
Robert a Patrick Individual Corporate DirectorBoard Member Oct 1, 2023
Patrick Naeger Individual Corporate DirectorBoard Member Oct 1, 2023
Sherry Clouse Day Individual Corporate OfficerTreasurer Oct 1, 2023

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 116

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

View all 116

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1952087546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 N WEST ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751359",
            "telephone_number": "573-541-2530",
            "fax_number": "573-517-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 N WEST ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751359",
            "telephone_number": "573-541-2530",
            "fax_number": "573-517-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL PERRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "CLOUSE DAY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "VP-FINANCE MERCY CAH",
        "authorized_official_telephone_number": "417-820-8439"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MO

Sources for this page

Verify at the official NPI Registry.