NPIMap

Organization Active NPI

Mercy Medical Center-Centerville

  • Home Health Agency
  • Centerville, IA
National Provider Identifier
1205023868
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
0163667 Issued in IA
Legal business name
MERCY MEDICAL CENTER-CENTERVILLE
Practice address
1 St. Joseph'S Drive
Centerville, IA 52544
Phone
(641) 437-4111
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Pam Young
Title
Business Office Manager
Phone
(641) 437-3413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 0163667 IA Primary

Addresses

Primary practice location

1 St. Joseph'S Drive
Centerville, IA 52544

Mailing address

1 St. Joseph'S Drive
Centerville, IA 52544
Phone (641) 437-4111

Other identifiers 1

IdentifierTypeStateIssuer
0163667MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Center Ce6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1205023868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ST. JOSEPH'S DRIVE",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "52544",
            "telephone_number": "641-437-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ST. JOSEPH'S DRIVE",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "52544",
            "telephone_number": "641-437-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER-CENTERVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "641-437-3413"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": "0163667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0163667",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.