Provider Demographics
NPI:1093723041
Name:MERCY KANSAS COMMUNITIES INC
Entity Type:Organization
Organization Name:MERCY KANSAS COMMUNITIES INC
Other - Org Name:MERCY HOSPITAL - INDEPENDENCE
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-625-2459
Mailing Address - Street 1:800 W MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-3240
Mailing Address - Country:US
Mailing Address - Phone:620-331-2200
Mailing Address - Fax:620-332-3270
Practice Address - Street 1:800 W MYRTLE ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3240
Practice Address - Country:US
Practice Address - Phone:620-331-2200
Practice Address - Fax:620-332-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-063-004261QE0002X, 261QP2300X, 282N00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000000041OtherBLUE CROSS
KS100089300AMedicaid
KS170010Medicare Oscar/Certification