NPIMap

Organization Active NPI

State University of Iowa

Doing business as UI Health Care North Liberty Pharmacy - Forevergreen Road

  • Pharmacy
  • North Liberty, IA
National Provider Identifier
1114732559
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
STATE UNIVERSITY OF IOWA
Doing business as
UI Health Care North Liberty Pharmacy - Forevergreen Road
Practice address
701 W Forevergreen Rd Ste 1605
North Liberty, IA 52317-9848
Phone
(319) 485-0300
Fax
(319) 353-8443
NPI assigned
Feb 12, 2025
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Joe M McKelvey
Title
Sr Director of Govt Reimbursement
Phone
(319) 467-8549

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

701 W Forevergreen Rd Ste 1605
North Liberty, IA 52317-9848

Mailing address

701 W Forevergreen Rd Ste 1605
North Liberty, IA 52317-9848
Phone (319) 485-0300

Other names 1

  • UI Health Care North Liberty Pharmacy - Forevergreen Road Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230420000460 IA Part B Supplier - Mass Immunization (Roster Biller Only) 7618884230 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coralville, IA; Des Moines, IA; Iowa City, IA; North Liberty, IA; Riverside, IA
O20250624002005 IA DME Supplier - Pharmacy 7618884230 Practice locations: North Liberty, IA

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Other NPIs on the same Medicare enrollment 6

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

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ui Health Care North Liberty Pharma701 W Forevergreen Rd, North Liberty, IA 52317-9848(319) 485-0300 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order) Accepts assignmentParticipating since Jan 1, 1970

National Provider Directory

National Provider Directory
Tax ID family
J Antonio G Lopez MD61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

200 Hawkins Dr
#1353
Iowa City, IA 52242
Phone (319) 384-5415

701 W Forevergreen Rd
Ste 1605
North Liberty, IA 52317
Phone (319) 485-0300

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Iowa Health Care Medical CenterIowa City, IA, CCN 160058 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical CenterIowa City, IA, CCN 16S058 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical Center DowntownIowa City, IA, CCN 160029 Hospital Other Jan 31, 2024
University of Iowa Health Care Medical Center Downtown Home HealthCoralville, IA, CCN 167181 Home health agency Other Jan 31, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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": "1739318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1114732559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W FOREVERGREEN RD STE 1605",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179848",
            "telephone_number": "319-485-0300",
            "fax_number": "319-353-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W FOREVERGREEN RD STE 1605",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179848",
            "telephone_number": "319-485-0300",
            "fax_number": "319-353-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE UNIVERSITY OF IOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-12",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "MCKELVEY",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR DIRECTOR OF GOVT REIMBURSEMENT",
        "authorized_official_telephone_number": "319-467-8549"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UI Health Care North Liberty Pharmacy - Forevergreen Road",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.