1. Home
  2. Directory
  3. Illinois
  4. Fulton
  5. Family Medicine
  6. NPI Profile

MERCYONE FULTON FAMILY MEDICINE
NPI 1487218079
Family Medicine in Fulton, IL

Active since April 29, 2019CLIA 14D0430589 · Waiver
1705 16TH AVE, FULTON, IL 61252(815) 589-2121(815) 589-4468 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 20, 2020, Jun 4, 2019, Apr 29, 2019 (3 updates tracked since 2019).

About Mercyone Fulton Family Medicine NPPES

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

MERCYONE FULTON FAMILY MEDICINE (NPI 1487218079) is a healthcare organization registered as a family medicine in Fulton, Illinois and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through April 3, 2027 and lists Mellissa Wood, Coo/cno, as its authorized official.

NPPES Registry Identity

NPI1487218079
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMERCY SPECIALTY CLINIC
Location Address1705 16TH AVEFulton, IL 61252-9708
Mailing Address621 S Illinois Ave Ste 103Mason City, IA 50401-5489 · (641) 428-3900 · Fax (641) 428-3059
Phone(815) 589-2121
Fax(815) 589-4468
Organization SubpartNo
Authorized OfficialMellissa WoodCoo/cno · (563) 244-5608
Enumeration DateApril 29, 2019
Last NPPES UpdateOctober 17, 20243 updates tracked since enumeration
NPPES CertifiedOctober 17, 2024
✔ NPI 1487218079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1705 16TH AVE, Fulton, IL 61252
Open in Google Maps ↗

Other Names 1

Doing Business AsMercyone Fulton Family Medicine

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

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 Waiver 14D0430589

Mercyone Fulton Family Medicine · Fulton, IL
Active · expires Apr 3, 2027
CLIA Number14D0430589
Laboratory TypePhysician Office
Certificate Effective DateApril 4, 2025
Certificate Expiration DateApril 3, 2027
Laboratory DirectorDr. Stephen D. Harrison
Laboratory Phone(815) 589-2121
Laboratory LocationMercyone Fulton Family Medicine1705 16th Av, Fulton, IL 61252
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

ADRIANNA VANDUYNE FNP
Nurse Practitioner
1705 16TH AVE
FULTON, IL 61252
Whiteside County (563) 243-2511
MEDICAL ASSOCIATES OF CLINTON, IOWA, P.L.C.
Family Medicine
1705 16TH AVE
FULTON, IL 61252
Whiteside County (815) 589-2121
STEPHANIE G HOLESINGER ARNP
Nurse Practitioner (Family)
1705 16TH AVE
FULTON, IL 61252
Whiteside County (815) 589-2121
DR. STEPHEN D HARRISON M.D.
Family Medicine
1705 16TH AVE
FULTON, IL 61252
Whiteside County (815) 589-2121
KIMBERLY K MULHOLLAND ARNP
Nurse Practitioner (Family)
1705 16TH AVE
FULTON, IL 61252
Whiteside County (815) 589-2121

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 Specialty Clinic's NPI number?

The NPI number for Mercy Specialty Clinic is 1487218079. It was assigned to this organization in the NPPES registry on April 29, 2019. The provider is doing business as Mercyone Fulton Family Medicine.

Where is Mercy Specialty Clinic located?

Mercy Specialty Clinic is located at 1705 16th Ave, Fulton, IL 61252. The listed phone number is (815) 589-2121.

What is Mercy Specialty Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Mercy Specialty Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0430589) is associated with this NPI, valid through April 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mercy Specialty Clinic accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Mercy Specialty Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mercy Specialty Clinic was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.