MERCY MEDICAL CENTER, INC. (NPI# 1609811181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609811181 |
| Entity Type | Organization |
| Organization Name | MERCY MEDICAL CENTER, INC. |
| Other Organization Name | MERCY MEDICAL CENTER HOME HEALTH SERVICE |
| Practice Address |
2675 Nw Edenbower Blvd Roseburg OR 97471-6201 |
| Practice Telephone | 5416772384 |
| Practice Fax Number | 5416772498 |
| Mailing Telephone | 5416772384 |
| Mailing Fax Number | 5416772498 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | KELLY C. MORGAN (CEO/PRESIDENT) |
| Authorized Official Telephone | 5416772466 |
| Is Organization Subpart | Y |
| Parent Organization Name | MERCY MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 141133 | OR | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 136770 | 05 |
| Other Name | Type Code |
|---|---|
| Mercy Medical Center Home Health Service | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2400 Nw Stewart Pkwy, Suite 200, Roseburg, OR 974715659 | 5416772458 | 5416771554 |
| 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 |
| 1841241270 | Mercy Medical Center, Inc. | Home Health | 7568 Whipple Ave Nw, North Canton, OH 44720-6922 | 2006-05-12 |
| 1013450287 | Mercy Medical Center, Inc. | Surgery | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2016-11-21 |
| 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 |
2675 NW EDENBOWER BLVD |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-6201 |
| 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 | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033157649 | Avalon Home Health LLC | Home Health | 847 Se Watson St, Roseburg, OR 97470-3926 | 2006-06-04 |
| 1891760328 | Integricare, Inc. | Home Health | 500 Se Cass Ave, Suite 260, Roseburg, OR 97470-3103 | 2006-02-20 |
| 1679908628 | History Makers, Inc. | Home Health | 220 Cinbar Dr, Roseburg, OR 97471-9385 | 2013-09-10 |
| 1093908725 | Amedisys Oregon, L.L.C. | Home Health | 1820 Nw Mulholland Dr, Roseburg, OR 97470-1945 | 2007-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215548508 | Helen Lacsina Greer | Home Health | 248 Elma Ave Se, Salem, OR 97317-5464 | 2020-08-11 |
| 1760092167 | Charlotte Kreftmeyer | Home Health | 661 Skyhawk Dr, Ontario, OR 97914-3143 | 2020-07-31 |
| 1275156929 | Amy Marie Mathis | Home Health | 1787 Easy St, Medford, OR 97504-5325 | 2020-05-28 |
| 1841810256 | Destiny Robin Thomas | Home Health | 2544 Ne Clackamas St, Portland, OR 97232-1727 | 2020-04-26 |
| 1912533506 | Lucas Home Care, LLC | Home Health | 230 Se 3rd St # 100, Bend, OR 97702-9949 | 2020-03-16 |
| 1700421682 | Janelle S Foote | Home Health | 36540 Highway 140, Beatty, OR 97621-9706 | 2019-11-14 |
| 1972154441 | For The People LLC | Home Health | 10700 Sw Beaverton Hillsdale Hwy Ste 4709, Beaverton, OR 97005-3019 | 2019-09-25 |
| 1093363426 | Apex Health and Wellness | Home Health | 436 N Laurel St, Ashland, OR 97520-1113 | 2019-08-28 |
| 1962056341 | Cascade Specialized Nursing, LLC. | Home Health | 20831 Se Firwood Rd, Sandy, OR 97055-9487 | 2019-07-24 |
| 1528620887 | Chareese R Borland | Home Health | 2240 Nolan Ln, West Linn, OR 97068-4243 | 2019-07-07 |
| Find all providers with the same taxonomy | ||||
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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.