NPIMap

Organization Active NPI

Mercy Rehabilitation Hospital, LLC

Doing business as Mercy Rehabilitation Hospital

  • Rehabilitation Hospital
  • Clive, IA
National Provider Identifier
1023520368
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
MERCY REHABILITATION HOSPITAL, LLC
Doing business as
Mercy Rehabilitation Hospital
Practice address
1401 Campus Drive
Clive, IA 50325-6500
Phone
(515) 381-6519
NPI assigned
Oct 26, 2017
Last updated
Oct 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Authorized official

Name
Nicole Nigg
Title
Hospital Ceo
Phone
(515) 381-6519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X NU Primary

Addresses

Primary practice location

1401 Campus Drive
Clive, IA 50325-6500

Mailing address

1401 Campus Drive
Clive, IA 50325-6500
Phone (515) 381-6519

Other names 1

  • Mercy Rehabilitation Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180322001773 IA Part A Provider - Hospital 9234491697 Practice locations: Clive, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023520368. Details of each certification follow.

Hospital certification: CCN 163025

Legal name
MERCY REHABILITATION HOSPITAL LLC
Doing business as
MERCY REHABILITATION HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Jul 24, 2018
Last certification
Jul 24, 2018
Beds
50
Ownership / control type
Private (not for profit)
Organization structure
LLCProprietary
Incorporated
Apr 21, 2016 in IA
Enrollment address
1401 Campus Dr
Clive, IA 50325-6500
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Mercy Rehabilitation Hospital, LLCCCN 163025 · All quality measures
Ownership
Non-profit
Certified
Jul 24, 2018
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2144042Mercy Rehabilitation Hospital1401 Campus Drive, Clive, IA 50325Certificate of waiverFeb 8, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Donna Flannery Individual Corporate DirectorBoard Member Feb 14, 2017
Lifepoint Rehab Blocker LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 49%
CHC Management Services LLC Organization, Brentwood, TN LLC, Management services company, For-profit Operational/Managerial Control Apr 26, 2016
Lifepoint Rehab LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 49%
Sally L Brooks Individual Corporate DirectorBoard Member Jan 22, 2020
DSB Acquisition LLC Organization, New York, NY LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 49%
Cindy L Penney Individual Corporate DirectorBoard Member Apr 27, 2021
Nicole Nigg Individual Corporate OfficerChief Executive Officer Oct 23, 2017
Operational/Managerial ControlHospital Ceo Oct 23, 2017
Lifepoint Health Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Dec 23, 2021 49%
Catholic Health Initiatives-Iowa Corp Organization, Des Moines, IA Corporation 5% Or Greater Direct Ownership Interest Apr 26, 2016 51%
Marcus B Poppell Individual OtherVice President Dec 23, 2021
KND Development 64 LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Direct Ownership Interest Apr 26, 2016 49%
Bruce L Hughes Individual Corporate DirectorBoard Member Feb 14, 2017
Robert Wise Individual Corporate DirectorBoard Member Dec 19, 2018
Lifepoint Rehab Blocker Parent LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 49%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 76

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 76

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 9

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1023520368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CAMPUS DRIVE",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503256500",
            "telephone_number": "515-381-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CAMPUS DRIVE",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503256500",
            "telephone_number": "515-381-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY REHABILITATION HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "NIGG",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "HOSPITAL CEO",
        "authorized_official_telephone_number": "515-381-6519"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.