Organization Active NPI

Mercy Clinics, Inc

Doing business as MercyOne Clive Physical Medicine & Rehabilitation

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Clive, IA
National Provider Identifier
1073853461
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X
Legal business name
MERCY CLINICS, INC
Doing business as
MercyOne Clive Physical Medicine & Rehabilitation
Practice address
12493 University Ave Ste 100
Clive, IA 50325
Phone
(515) 358-9461
Fax
(515) 358-9489
NPI assigned
Feb 21, 2013
Last updated
Oct 10, 2024By the provider in NPPES
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
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician 2081N0008X Primary

Addresses

Primary practice location

12493 University Ave Ste 100
Clive, IA 50325

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-9461

Other names 1

  • MercyOne Clive Physical Medicine & Rehabilitation 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

National Provider Directory

National Provider Directory

Locations

12493 University Ave
Clive, IA 50325
Phone (515) 282-9622

12493 University Ave
Ste 100
Des Moines, IA 50325
Phone (515) 358-0060

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1073853461",
    "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": "515-358-9461",
            "fax_number": "515-358-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12493 UNIVERSITY AVE STE 100",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "50325",
            "telephone_number": "515-358-9461",
            "fax_number": "515-358-9489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "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": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MercyOne Clive Physical Medicine & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clive, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.