NPIMap

Organization Active NPI

Mary Greeley Medical Center

  • Land Ambulance
  • Ames, IA
National Provider Identifier
1447470463
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
2850100 Issued in IA
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
May 1, 2007
Last updated
Nov 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 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
Land Ambulance 3416L0300X 2850100 IA Primary

Addresses

Primary practice location

1111 Duff Ave
Ames, IA 50010-5745

Mailing address

1111 Duff Ave
Ames, IA 50010-5745
Phone (515) 239-2112

Other identifiers 2

IdentifierTypeStateIssuer
2850100OtherIAMOBILE INTENSIVE CARE SERVICES
0112573MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200929002195 IA Part B Supplier - Ambulance Service Supplier 6507769247 Practice locations: Ames, IA

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Kalyan Sajja MD13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All facility ownership & control disclosures 3

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
Mary Greeley Medical CenterAmes, IA, CCN 16S030 Hospital Operational/Managerial Control (100%) Jul 19, 2007

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1447470463",
    "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": "515-239-2112",
            "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": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "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": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2850100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOBILE INTENSIVE CARE SERVICES",
            "identifier": "2850100",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112573",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.