NPIMap

Organization Active NPI

Mercy Medical Center-Centerville

  • Home Health Agency
  • Centerville, IA
National Provider Identifier
1083664361
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MERCY MEDICAL CENTER-CENTERVILLE
Doing business as
Mercy Home Care
Practice address
19898 Saint Joseph Drive
Centerville, IA 52544-9088
Phone
(641) 437-4111
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Authorized official

Name
Pam Young
Title
Business Office Manager
Phone
(641) 437-3413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IA Primary

Addresses

Primary practice location

19898 Saint Joseph Drive
Centerville, IA 52544-9088

Mailing address

1 Saint Joseph Drive
Centerville, IA 52544-9088

Other identifiers 2

IdentifierTypeStateIssuer
0672212MedicaidIA
67221OtherIAWELLMARK

Other names 1

  • Mercy Home Care Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1083664361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT JOSEPH DRIVE",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525449088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19898 SAINT JOSEPH DRIVE",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525449088",
            "telephone_number": "641-437-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER-CENTERVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "641-437-3413"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672212",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "67221",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centerville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.