Active NPI
Mercy Clinics, Inc
- Family Medicine Physician
- Ankeny, IA
National Provider Identifier
1043440803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
- MercyOne Ankeny Prairie Trail Family Medicine Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0663194 | Mercyone Ankeny Prairie Trail | Certificate of waiver | May 14, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Ankeny, IA
- NPI 1639189293
-
- Physician Assistant
- Ozark, MO
- NPI 1417096058
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.