NPIMap

Organization Active NPI

Mercy Clinics Inc

  • Pediatric Adolescent Medicine Physician
  • Des Moines, IA
National Provider Identifier
1407036262
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
MERCY CLINICS INC
Practice address
330 Laurel St
Suite 2100
Des Moines, IA 50314-3034
Phone
(515) 643-8611
Fax
(515) 643-8812
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Bradley Whipple
Title
Coo
Phone
(515) 358-6956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

330 Laurel St
Suite 2100
Des Moines, IA 50314-3034

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-4374

Other practice location 1

25 W Hickman Rd
Waukee, IA 50263-5020
Phone (515) 643-7000

Other practice location 2

5406 Merle Hay Rd
Johnston, IA 50131-1209
Phone (515) 727-8750

Other identifiers 1

IdentifierTypeStateIssuer
0236174MedicaidIA

Other names 2

  • MercyOne Des Moines Pediatrics Care Clinc Doing business as
  • MercyOne Waukee Pediatrics Care Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000238 IA Part B Supplier - Clinic/Group Practice 7911810882 Receives reassigned benefits from 558 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

25 W Hickman Rd
Waukee, IA 50263
Phone (515) 358-0150

Practitioners & affiliated clinicians

Practitioners 8

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": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1407036262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-4374",
            "fax_number": "515-643-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAUREL ST",
            "address_2": "SUITE 2100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143034",
            "telephone_number": "515-643-8611",
            "fax_number": "515-643-8812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 W Hickman Rd",
            "address_purpose": "LOCATION",
            "city": "Waukee",
            "state": "IA",
            "postal_code": "502635020",
            "country_code": "US",
            "telephone_number": "515-643-7000",
            "fax_number": "515-643-7001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5406 Merle Hay Rd",
            "address_purpose": "LOCATION",
            "city": "Johnston",
            "state": "IA",
            "postal_code": "501311209",
            "country_code": "US",
            "telephone_number": "515-727-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCY CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "WHIPPLE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "515-358-6956"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236174",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MercyOne Des Moines Pediatrics Care Clinc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MercyOne Waukee Pediatrics Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.