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MERCY CLINIC-BERRYVILLE-WALMART
NPI 1083924294
Nurse Practitioner - Family in Berryville, AR

Active since October 21, 2010CLIA 04D0468429 · Certificate of Compliance
1000 W TRIMBLE AVE, BERRYVILLE, AR 72616(870) 423-4472(870) 423-7178 Get Directions Write a Review

NPPES record last updated: August 13, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mercy Clinic-berryville-walmart NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MERCY CLINIC-BERRYVILLE-WALMART (NPI 1083924294) is a healthcare organization registered as a family in Berryville, Arkansas and active in the NPI registry since October 2010. The organization holds a CLIA Certificate of Compliance certificate valid through December 6, 2026 and lists Donn E. Sorensen, Executive Vice President, Coo, as its authorized official.

NPPES Registry Identity

NPI1083924294
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameMERCY CLINIC-SPRINGFIELD COMMUNITIES
Location Address1000 W TRIMBLE AVEBerryville, AR 72616-4603
Mailing AddressPo Box 2580Springfield, MO 65801-2580 · (417) 829-4620
Phone(870) 423-4472
Fax(870) 423-7178
Organization SubpartNo
Authorized OfficialDonn E. SorensenExecutive Vice President, Coo · (417) 820-6556
Enumeration DateOctober 21, 2010
Last NPPES UpdateAugust 13, 2013
✔ NPI 1083924294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AR · A01264
1000 W TRIMBLE AVE, Berryville, AR 72616
Open in Google Maps ↗

Other Names 1

Doing Business AsMercy Clinic-berryville-walmart

Other Identifiers 2

Medicaid1083924294AR
Medicare PIN5G709AR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 04D0468429

Mercy Clinic Berryville · Berryville, AR
Active · expires Dec 6, 2026
CLIA Number04D0468429
Laboratory TypePhysician Office
Certificate Effective DateDecember 7, 2024
Certificate Expiration DateDecember 6, 2026
Laboratory DirectorPhillip E. Ferguson
Laboratory Phone(870) 423-6661
Laboratory LocationMercy Clinic Berryville207 Carter Street, Berryville, AR 72616
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHEALA RODEN
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Carroll County (870) 234-5421
MCKENZIE KOCH PHARMD
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Carroll County (870) 423-6611
KERRY LYNN BOLEY RPH
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Carroll County (870) 423-6611
MR. BRADLEY JAMES OWENS PD
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Carroll County (870) 423-6611
JILLIAN NICOLE SCHMIDT PHARMD
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Carroll County (870) 423-6611
JUANA PEREZ OSORNIO
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Carroll County (870) 423-6611
WALMART INC.
Pharmacy (Community/Retail Pharmacy)
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Carroll County (870) 423-6611

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mercy Clinic-Springfield Communities's NPI number?

The NPI number for Mercy Clinic-Springfield Communities is 1083924294. It was assigned to this organization in the NPPES registry on October 21, 2010. The provider is doing business as Mercy Clinic-Berryville-Walmart.

Where is Mercy Clinic-Springfield Communities located?

Mercy Clinic-Springfield Communities is located at 1000 W Trimble Ave, Berryville, AR 72616. The listed phone number is (870) 423-4472.

What is Mercy Clinic-Springfield Communities's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Mercy Clinic-Springfield Communities hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 04D0468429) is associated with this NPI, valid through December 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mercy Clinic-Springfield Communities was last updated on August 13, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.