NPIMap

Organization Active NPI

Catholic Health Initiatives-Iowa Corp

Doing business as MercyOne Des Moines Laboratory

  • Clinical Medical Laboratory
  • Des Moines, IA
National Provider Identifier
1104982743
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CATHOLIC HEALTH INITIATIVES-IOWA CORP
Doing business as
MercyOne Des Moines Laboratory
Practice address
1111 6TH Ave
Des Moines, IA 50314-2610
Phone
(515) 643-8200
NPI assigned
Dec 28, 2006
Last updated
Oct 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Kurt Andersen
Title
President
Phone
(515) 358-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1111 6TH Ave
Des Moines, IA 50314-2610

Mailing address

PO Box 4867
Des Moines, IA 50305-4867
Phone (515) 643-8200

Other identifiers 1

IdentifierTypeStateIssuer
3600833MedicaidIA

Other names 1

  • MercyOne Des Moines Laboratory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071106000163 IA Part A Provider - Hospital 5698683142 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104982743. Details of each certification follow.

Hospital certification: CCN 160083

Legal name
CATHOLIC HEALTH INITIATIVES-IOWA CORP
Doing business as
MERCYONE DES MOINES MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 10, 2017
Beds
649 (596 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1111 6TH Ave
Des Moines, IA 50314-2613
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercyone Des Moines Medical CenterCCN 160083 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
16D0383702Mercyone Des Moines Medical Center1111 6TH Avenue, Des Moines, IA 50314AccreditationOct 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Catholic Health Initiatives-Iowa Corp16 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

800 E 1st St
Ste 1400
Ankeny, IA 50021

1601 NW 114th St
Ste 134
Clive, IA 50325

411 Laurel St
Ste A265
Des Moines, IA 50314

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Christopher Nelson Individual Corporate DirectorBoard Member Jul 1, 2020
Neil R Horning Individual Corporate OfficerSecretary Jan 1, 2024
Corporate DirectorBoard Member Jul 1, 2020
Stephen R Nowak Individual Corporate DirectorBoard Member Jul 1, 2020
Timothy Miller Individual Corporate DirectorBoard Member Jul 1, 2020
Maurita Soukup Individual Corporate DirectorBoard Member Jul 1, 2020
Emily Abbas Individual Corporate DirectorBoard Member Jul 1, 2018
Michael C Fraizer Individual Corporate DirectorBoard Member Jun 30, 2022
Vanessa L Freitag Individual Corporate OfficerCoo Apr 15, 2024
Corporate DirectorBoard Member Apr 15, 2024
W-2 Managing EmployeeCoo Apr 15, 2024
Brian Johnson Individual Corporate OfficerTreasurer Jan 1, 2025
Corporate DirectorBoard Member Jul 1, 2018
Mercy Health Network Inc Organization, Des Moines, IA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 1, 2022 100%
Theresa McConeghey Individual Corporate OfficerChair Jan 1, 2018
Corporate DirectorBoard Member Jan 1, 2018
Kurt a Andersen Individual Corporate OfficerPresident Central Division Mercyone Jan 24, 2024
W-2 Managing EmployeePresident Central Division Mercyone Jan 24, 2024
Patricia McDermott Individual Corporate DirectorBoard Member Jun 1, 2017
Erin E Netteland Sandvig Individual Corporate DirectorBoard Member Jun 30, 2022
Paul Hedinger Individual Corporate OfficerVP of Finance Apr 28, 2026
W-2 Managing EmployeeVP of Finance Apr 28, 2026
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2022 100%

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 1,224

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

View all 1,224

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1104982743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4867",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503054867",
            "telephone_number": "515-643-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142610",
            "telephone_number": "515-643-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC HEALTH INITIATIVES-IOWA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-358-9200"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3600833",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MercyOne Des Moines Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.