Organization Active NPI

Mercy Clinics, Inc

  • Family Medicine Physician
  • Ankeny, IA
National Provider Identifier
1043440803
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY CLINICS, INC
Practice address
2605 SW White Birch Dr
Ankeny, IA 50023-7235
Phone
(515) 643-7100
Fax
(515) 643-7145
NPI assigned
Jul 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Bradley Whipple
Title
Chief Operating Officer
Phone
(515) 358-6956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2605 SW White Birch Dr
Ankeny, IA 50023-7235

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-7100

Other names 2

  • Mercy Prairie Trail Family Medicine Doing business as
  • MercyOne Ankeny Prairie Trail Family Medicine Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000238 IA Part B Supplier - Clinic/Group Practice 7911810882 Receives reassigned benefits from 558 practitioners
This NPI is an additional NPI on the enrollment

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
16D0663194Mercyone Ankeny Prairie Trail2605 SW White Birch, Ankeny, IA 50023Certificate of waiverMay 14, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1043440803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-7100",
            "fax_number": "515-643-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 SW WHITE BIRCH DR",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237235",
            "telephone_number": "515-643-7100",
            "fax_number": "515-643-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "WHIPPLE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "515-358-6956"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Prairie Trail Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MercyOne Ankeny Prairie Trail Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.