NPIMap

Organization Active NPI

Mental Health Institute

  • Psychiatry Physician
  • Independence, IA
National Provider Identifier
1023069440
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
100068H Issued in IA
Legal business name
MENTAL HEALTH INSTITUTE
Practice address
2277 Iowa Ave
Independence, IA 50644-9106
Phone
(319) 334-2583
Fax
(319) 334-5252
NPI assigned
May 12, 2006
Organization subpart
Yes
Parent organization
MENTAL HEALTH INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bhasker Dave, M.D.
Title
Superintendant
Phone
(319) 334-2583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 100068H IA Primary

Addresses

Primary practice location

2277 Iowa Ave
Independence, IA 50644-9106

Mailing address

2277 Iowa Ave
Independence, IA 50644-9106
Phone (319) 334-2583

Other identifiers 2

IdentifierTypeStateIssuer
30832OtherIAB.C.B.S. OF IOWA GRP. PRA
0096867MedicaidIA

Other names 1

  • Psychiatric Phsycians Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001515 IA Part B Supplier - Clinic/Group Practice 5496646978 Receives reassigned benefits from 8 practitioners
Practice locations: Independence, IA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Mental Health Institute

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mental Health InstituteIndependence, IA, CCN 164003 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 23, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1023069440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583",
            "fax_number": "319-334-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583",
            "fax_number": "319-334-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH INSTITUTE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MENTAL HEALTH INSTITUTE",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "DAVE",
        "authorized_official_first_name": "BHASKER",
        "authorized_official_title_or_position": "SUPERINTENDANT",
        "authorized_official_telephone_number": "319-334-2583",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "100068H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B.C.B.S. OF IOWA GRP. PRA",
            "identifier": "30832",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096867",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Phsycians Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, IA

Sources for this page

Verify at the official NPI Registry.