NPIMap

Organization Active NPI

Mercy Physician Associates, Inc

Doing business as MercyCare Mt. Vernon

  • Family Medicine Physician
  • Mount Vernon, IA
National Provider Identifier
1174720940
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
Doing business as
MercyCare Mt. Vernon
Practice address
310 Highway 1 SE
Mt. Vernon, IA 52314
Phone
(319) 369-4798
NPI assigned
Jun 27, 2007
Last updated
Feb 1, 2011By the provider in NPPES
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

310 Highway 1 SE
Mt. Vernon, IA 52314

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824

Other identifiers 1

IdentifierTypeStateIssuer
0792390MedicaidIA

Other names 1

  • MercyCare Mt. Vernon 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
Tax ID family
Mercy Physicians Assoc15 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

310 Highway 1 S
Mount Vernon, IA 52314
Phone (319) 861-7900

Practitioners & affiliated clinicians

Practitioners 4

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": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1174720940",
    "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": "310 HIGHWAY 1 SE",
            "city": "MT. VERNON",
            "state": "IA",
            "postal_code": "52314",
            "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": "0792390",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MercyCare Mt. Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, 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.