MERCY MEDICAL CENTER, INC. (NPI# 1013450287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013450287 |
| Entity Type | Organization |
| Organization Name | MERCY MEDICAL CENTER, INC. |
| Other Organization Name | CENTER FOR WOUND HEALING AND HYPERBARIC THERAPY |
| Practice Address |
2700 Nw Stewart Pkwy Roseburg OR 97471-1281 |
| Mailing Address |
2801 Nw Mercy Dr Ste 340 Roseburg OR 97471-2348 |
| Practice Telephone | 5416774319 |
| Practice Fax Number | 5416772294 |
| Mailing Telephone | 5416774319 |
| Mailing Fax Number | 5416772294 |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2017-02-01 |
| Authorized Official Name | DOUG KLEBE (VICE PRESIDENT) |
| Authorized Official Telephone | 5416773650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Center for Wound Healing and Hyperbaric Therapy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215106133 | Mercy Medical Center, Inc. | Surgery | 2700 Nw Stewart Parkway, Roseburg, OR 97471 | 2008-02-25 |
| 1649208802 | Mercy Medical Center, Inc. | Hospice Care, Community Based | 2675 Nw Edenbower Blvd Ste 200, Roseburg, OR 97471-6201 | 2006-06-28 |
| 1609811181 | Mercy Medical Center, Inc. | Home Health | 2675 Nw Edenbower Blvd, Roseburg, OR 97471-6201 | 2006-06-18 |
| 1841241270 | Mercy Medical Center, Inc. | Home Health | 7568 Whipple Ave Nw, North Canton, OH 44720-6922 | 2006-05-12 |
| 1194155549 | Mercy Medical Center, Inc. | Clinic/Center | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2013-11-21 |
| 1306182332 | Mercy Medical Center, Inc. | General Acute Care Hospital | 1031 W High Ave, New Philadelphia, OH 44663-2071 | 2012-12-19 |
| 1023362100 | Mercy Medical Center, Inc. | Clinic/Center | 1459 Superior Ave Ne, Canton, OH 44705-1964 | 2012-10-29 |
| 1326282807 | Mercy Medical Center, Inc. | Clinical Medical Laboratory | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2009-04-28 |
| 1225231103 | Mercy Medical Center, Inc. | Prosthetic/Orthotic Supplier | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2007-06-07 |
| 1811038367 | Mercy Medical Center, Inc. | Psychiatric Unit | 2700 Nw Stewart Pkwy, Roseburg, OR 97470-1281 | 2007-02-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MERCY MEDICAL CENTER, INC | 301 Saint Paul Pl, Baltimore, MD 21202-2102 |
| System for Award Management (SAM) Entities | MERCY MEDICAL CENTER, INC. | 1320 Mercy Dr Nw, Canton, OH 44708-2614 |
| Oregon Corporations, Companies and Business Names | MERCY MEDICAL CENTER, INC. | 2700 Stewart Parkway, Roseburg, OR 97471 |
| Street Address |
2700 NW STEWART PKWY |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-1281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790766822 | Mercy Healthcare, Inc | General Acute Care Hospital | 2700 Nw Stewart Pkwy, Roseburg, OR 97470-1281 | 2005-11-07 |
| 1902412505 | Lisa Mai | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1214 | 2020-09-18 |
| 1609480359 | Jacob Watters | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2020-09-01 |
| 1245843143 | Marcus Lee David Sickelton | Student in an Organized Health Care Education/Training Program | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1214 | 2020-08-28 |
| 1053978403 | Shelli Cross | Registered Nurse | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2019-05-21 |
| 1225695711 | Christa Lynne Creech | Pharmacist | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2019-05-21 |
| 1366007510 | Nikki Jean Whiting | Nurse Practitioner | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2019-05-03 |
| 1629554811 | Gary Sorcher | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-11 |
| 1548756158 | Timothy Lawrence Garvey Jr. | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-06 |
| 1437645223 | Kimberly Ann Romano | Registered Nurse | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164782728 | Brent L Soder | Surgery | 2801 Nw Mercy Dr Ste 330, Roseburg, OR 97471-2348 | 2012-05-16 |
| 1215106133 | Mercy Medical Center, Inc. | Surgery | 2700 Nw Stewart Parkway, Roseburg, OR 97471 | 2008-02-25 |
| 1992887103 | Eric A Soder | Surgery | 2570 Nw Edenbower #101, Roseburg, OR 97470-6214 | 2006-10-19 |
| 1457327058 | Paul C Kremser | Surgery | 489 Cherokee Ave, Roseburg, OR 97470-9534 | 2006-02-24 |
| 1538543012 | Jenni Lynne Nix | Surgery | 2801 Nw Mercy Dr Ste 330, Roseburg, OR 97471-2348 | 2015-07-15 |
| 1457695546 | Mark N Donovan | Surgery | 2801 Nw Mercy Dr Ste 330, Roseburg, OR 97471 | 2012-11-15 |
| 1265664742 | Centennial Medical Group | Surgery | 2570 Nw Edenbower Blvd, Suite 101, Roseburg, OR 97471-6214 | 2009-08-17 |
| 1356517098 | Bryan Michael Mcvay | Surgery | 2801 Nw Mercy Dr, Suite 330, Roseburg, OR 97471-6214 | 2008-05-02 |
| 1841463064 | Eric A. Soder, M.d.,p.c. | Surgery | 2570 Nw Edenbower Blvd, Suite 101, Roseburg, OR 97470-6214 | 2008-04-09 |
| 1588679955 | Howard Robert Bourdages | Surgery | 913 Nw Garden Valley Blvd, Roseburg, OR 97470-6523 | 2006-07-31 |
| Find all providers in ROSEBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.