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

NPI Status: Active since October 21, 2010

Contact Information

1000 W TRIMBLE AVE
BERRYVILLE, AR
ZIP 72616
Phone: (870) 423-4472
Fax: (870) 423-7178

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  • Organization
  • Nurse Practitioner
  • Family
  • CLIA Number: 04D0468429
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-06-2026

About MERCY CLINIC-BERRYVILLE-WALMART

This page provides the complete NPI Profile along with additional information for Mercy Clinic-berryville-walmart, a provider established in Berryville, Arkansas operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1083924294 assigned on October 2010. The practitioner's primary taxonomy code is 363LF0000X with license number A01264 (AR). The provider is registered as an organization and their NPI record was last updated 13 years ago. Mercy Clinic-berryville-walmart operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Mercy Clinic-berryville-walmart. The authorized official of this NPI record is Donn E. Sorensen (Executive Vice President, Coo)

NPI
1083924294
Provider Legal Name
MERCY CLINIC-SPRINGFIELD COMMUNITIES
Other Organization Name
MERCY CLINIC-BERRYVILLE-WALMART
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1000 W TRIMBLE AVE BERRYVILLE, AR 72616
Location Phone
(870) 423-4472
Location Fax
(870) 423-7178
Mailing Address
PO BOX 2580 SPRINGFIELD, MO 65801
Mailing Phone
(417) 829-4620
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-21-2010
Last Update Date
08-13-2013
Code Navigator

A nurse practitioner (NP) like Mercy Clinic-berryville-walmart is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
A01264
License State
AR

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DONN E. SORENSEN

Authorized Official Title
EXECUTIVE VICE PRESIDENT, COO
Authorized Official Phone
(417) 820-6556

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1083924294MEDICAID (05)AR 
5G709MEDICARE PIN (08)AR 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
04D0468429
Facility Type
Physician Office
Certificate Effective Date
December 07, 2024
Certificate Expiration Date
December 06, 2026
Laboratory Director
PHILLIP E. FERGUSON
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Mercy Clinic-berryville-walmart after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

Reviews for MERCY CLINIC-BERRYVILLE-WALMART

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1083924294, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
2
Unchanged
Pos 7
4
Doubled → 8
Pos 8
2
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 9 → 18 → 9 4 → 8 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 6 + 3 + 1 + 8 + 2 + 8 + 2 + 1 + 8 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1083924294.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Pharmacy (Community/Retail Pharmacy)
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616
Pharmacist
1000 W TRIMBLE AVE
BERRYVILLE, AR 72616

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083924294, enumerated as an "organization" on October 21, 2010.

The provider is located at 1000 W TRIMBLE AVE BERRYVILLE, AR 72616 and the phone number is (870) 423-4472.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.