NPIMap

Organization Active NPI

Mercy Health Services- Iowa Corp

Doing business as MercyOne Mason City Home Medical Shop

  • Durable Medical Equipment & Medical Supplies
  • Mason City, IA
National Provider Identifier
1164475224
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MERCY HEALTH SERVICES- IOWA CORP
Doing business as
MercyOne Mason City Home Medical Shop
Practice address
1501 4TH St SW
Mason City, IA 50401-2737
Phone
(641) 428-5920
NPI assigned
May 18, 2006
Last updated
May 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Connie Morrison
Title
Director
Phone
(641) 428-6182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1501 4TH St SW
Mason City, IA 50401-2737

Mailing address

PO Box 1447
Mason City, IA 50402-1447
Phone (641) 428-6444

Other identifiers 2

IdentifierTypeStateIssuer
0484238MedicaidIA
59414OtherIAWELLMARK BCBS

Other names 1

  • MercyOne Mason City Home Medical Shop Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930055687 IA DME Supplier - Medical Supply Company 8628093192 Practice locations: Mason City, IA

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Mercy Health Services- Iowa Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Lutheran Retirement HomeNorthwood, IA, CCN 165485 Skilled nursing facility Adp of the SNF May 27, 2021

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1164475224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504021447",
            "telephone_number": "641-428-6444",
            "fax_number": "641-428-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 4TH ST SW",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012737",
            "telephone_number": "641-428-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH SERVICES- IOWA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "641-428-6182"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0484238",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "59414",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MercyOne Mason City Home Medical Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.