NPIMap

Organization Active NPI

Mercy Physician Associates, Inc

  • Family Medicine Physician
  • North Liberty, IA
National Provider Identifier
1164629937
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY PHYSICIAN ASSOCIATES, INC
Practice address
1765 Lininger Lane
North Liberty, IA 52317
Phone
(319) 369-4798
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Authorized official

Name
Annette J Stanton
Title
Sr Director
Phone
(319) 369-4512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1765 Lininger Lane
North Liberty, IA 52317

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824

Other identifiers 1

IdentifierTypeStateIssuer
0792606MedicaidIA

Other names 1

  • Mercy Care North Liberty Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000805 IA Part B Supplier - Clinic/Group Practice 1355242496 Receives reassigned benefits from 135 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Central City, IA; Cedard Rapids, IA; Hiawatha, IA; Manchester, IA; Marengo, IA; Marion, IA; Monticello, IA; Mt Vernon, IA…

Other NPIs on the same Medicare enrollment 29

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

View all 29

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1164629937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 LININGER LANE",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "52317",
            "telephone_number": "319-369-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY PHYSICIAN ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "STANTON",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR DIRECTOR",
        "authorized_official_telephone_number": "319-369-4512"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0792606",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Care North Liberty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.