NPIMap

Organization Active NPI

Mercy Medical Center-Centerville

  • Land Ambulance
  • Centerville, IA
National Provider Identifier
1255484903
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
MERCY MEDICAL CENTER-CENTERVILLE
Doing business as
MercyOne Centerville Medical Center
Practice address
1 Saint Joseph Dr
Centerville, IA 52544-9017
Phone
(641) 437-4111
Fax
(641) 437-3422
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1 Saint Joseph Dr
Centerville, IA 52544-9017

Mailing address

1 Saint Joseph Dr
Centerville, IA 52544-9017
Phone (641) 437-4111

Other identifiers 2

IdentifierTypeStateIssuer
0049098MedicaidIA
1255484903MedicaidIA

Other names 1

  • MercyOne Centerville Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL pyoung@mercydesmoines.org Direct

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1255484903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT JOSEPH DR",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525449017",
            "telephone_number": "641-437-4111",
            "fax_number": "641-437-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT JOSEPH DR",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525449017",
            "telephone_number": "641-437-4111",
            "fax_number": "641-437-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER-CENTERVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2019-04-30",
        "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",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049098",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255484903",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pyoung@mercydesmoines.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Saint Joseph Dr",
            "city": "Centerville",
            "state": "IA",
            "country_code": "US",
            "postal_code": "525449017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MercyOne Centerville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 30, 2019; 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.