NPIMap

Organization Active NPI

Mary Greeley Medical Center

  • Psychiatric Hospital Unit
  • Ames, IA
National Provider Identifier
1366428161
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MARY GREELEY MEDICAL CENTER
Practice address
1111 Duff Ave
Ames, IA 50010-5745
Phone
(515) 239-2011
Fax
(515) 239-2060
NPI assigned
Dec 22, 2005
Last updated
Dec 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MARY GREELEY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Amber Deardorff
Title
President/Ceo
Phone
(515) 239-2105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

1111 Duff Ave
Ames, IA 50010-5745

Mailing address

1111 Duff Ave
Ames, IA 50010-5745
Phone (515) 239-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322001956 IA Part B Supplier - Clinic/Group Practice 6507769247 Receives reassigned benefits from 35 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ames, IA
O20070802000689 IA Part A Provider - Hospital 6507769247 Practice locations: Ames, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366428161. Details of each certification follow.

Hospital certification: CCN 16S030

Legal name
MARY GREELEY MEDICAL CENTER
Doing business as
MARY GREELEY MEDICAL CENTER
Organization structure
GovernmentNon-profit
Enrollment address
1111 Duff Ave
Ames, IA 50010-5745
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Mary Greeley ER Physici13 organizations share this tax ID, including this one
Part of
Mary Greeley ER Physici

Other organizations with this tax ID 12

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

Locations

1111 Duff Ave
Ste 1431
Ames, IA 50010
Phone (515) 239-2011

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amber Deardorff Individual Corporate OfficerPresident/Ceo Aug 1, 2025
Corporate DirectorVP Clinical and Support Services May 28, 2017
W-2 Managing EmployeeClinical Applications Manager Mar 1, 2009
Paul B. Hudson Individual Corporate DirectorBoard of Directors May 8, 2026
City of Ames Iowa Organization, Ames, IA Non-profit 5% Or Greater Direct Ownership Interest Jul 19, 2007 100%
Operational/Managerial Control Jul 19, 2007 100%
Mary Greeley Medical Center Organization, Ames, IA Non-profit Operational/Managerial Control Jul 19, 2007 100%
Natallia Gray Individual Corporate DirectorBoard of Directors Jan 1, 2025
Kenneth D McCuskey Individual Corporate Director Jul 19, 2007
Austin Don Woodin Individual Corporate Director Jan 1, 2021
Mary Beth Swanson Individual Corporate Director Jan 1, 2018

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mary Greeley Medical CenterAmes, IA, CCN 160030 Hospital Operational/Managerial Control (100%) Jul 19, 2007
Mary Greeley Medical CenterAmes, IA, CCN 16T030 Hospital Operational/Managerial Control (100%) Jul 19, 2007

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1366428161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DUFF AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105745",
            "telephone_number": "515-239-2011",
            "fax_number": "515-239-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DUFF AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105745",
            "telephone_number": "515-239-2011",
            "fax_number": "515-239-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY GREELEY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY GREELEY MEDICAL CENTER",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "DEARDORFF",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "515-239-2105"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.