NPIMap

Organization Active NPI

Mercy Medical Services

  • Family Medicine Physician
  • Sioux City, IA
National Provider Identifier
1366484263
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY MEDICAL SERVICES
Practice address
801 5TH St
Suite 201
Sioux City, IA 51101-1394
Phone
(712) 279-2925
Fax
(712) 279-5883
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Brian K. Monsma
Title
Network Executive Director
Phone
(712) 279-2925

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

801 5TH St
Suite 201
Sioux City, IA 51101-1394

Mailing address

PO Box 328
Sioux City, IA 51102-0328
Phone (712) 279-5830

Other identifiers 1

IdentifierTypeStateIssuer
0417873MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1366484263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511020328",
            "telephone_number": "712-279-5830",
            "fax_number": "712-279-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 5TH ST",
            "address_2": "SUITE 201",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011394",
            "telephone_number": "712-279-2925",
            "fax_number": "712-279-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "MONSMA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "NETWORK EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "712-279-2925"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0417873",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.