Active NPI
Katherine Louise Mercuris, P.T.
- Physical Therapist
- Des Moines, IA
National Provider Identifier
1194717660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00830
- Practice address
- 3200 Grand Ave
Des Moines, IA 50312-4104 - Phone
- (515) 271-1717
- Fax
- (515) 271-7185
- NPI assigned
- Aug 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00830 | IA | Primary |
Addresses
Primary practice location
3200 Grand Ave
Des Moines, IA 50312-4104
Mailing address
3200 Grand Ave
Des Moines, IA 50312-4104
Phone (515) 271-1717
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0232843 | Medicaid | IA | |
| 650020383 | Other | IA | RR MEDICARE |
Other names 1
- Kathy Louise Mercuris
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00830 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1194717660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 GRAND AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503124104",
"telephone_number": "515-271-1717",
"fax_number": "515-271-7185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 GRAND AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503124104",
"telephone_number": "515-271-1717",
"fax_number": "515-271-7185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCURIS",
"first_name": "KATHERINE",
"middle_name": "LOUISE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-19",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "00830",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0232843",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "650020383",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHY",
"last_name": "MERCURIS",
"middle_name": "LOUISE",
"credential": "P.T.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.