NPIMap

Organization Active NPI

Mercy Medical Center

Doing business as Mercy Inpatient Rehabilitation

  • Rehabilitation Hospital Unit
  • Cedar Rapids, IA
National Provider Identifier
1467639062
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
57036H Issued in IA
Legal business name
MERCY MEDICAL CENTER
Doing business as
Mercy Inpatient Rehabilitation
Practice address
701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone
(319) 398-6011
Fax
(319) 398-6912
NPI assigned
Jan 25, 2008
Last updated
Jul 6, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Authorized official

Name
Mr. Timothy L Charles
Title
President and Ceo
Phone
(319) 398-6133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 57036H IA Primary

Addresses

Primary practice location

701 10TH St SE
Cedar Rapids, IA 52403-1251

Mailing address

701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone (319) 398-6011

Other names 1

  • Mercy Inpatient Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080206000588 IA Part A Provider - Hospital 4183535271 Practice locations: Cedar Rapids, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467639062. Details of each certification follow.

Hospital certification: CCN 16T079

Legal name
MERCY MEDICAL CENTER
Doing business as
MERCY MEDICAL CENTER CEDAR RAPIDS IA
Organization structure
CorporationNon-profit
Enrollment address
701 10TH St SE
Cedar Rapids, IA 52403-1251
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation

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

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Mercy Medical Center - Cedar RapidsCCN 16T079 · All quality measures
Ownership
Non-profit
Certified
Jul 1, 2008

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Center10 organizations share this tax ID, including this one
Part of
Mercy Medical Center

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Gregory B Dewolf Individual Corporate OfficerInterim President & C.E.O. Apr 4, 2026
Corporate DirectorInterim President & C.E.O. Apr 4, 2026
W-2 Managing EmployeeInterim President & C.E.O. Apr 4, 2026 100%
Operational/Managerial ControlInterim President & C.E.O. Apr 4, 2026 100%
Cheryle W Mitvalsky Individual Corporate OfficerBoard of Trustees Chairwoman Feb 2, 2022
Maurita Soukup Individual Corporate OfficerBoard of Trustees - Secretary Feb 2, 2022
Fred J Pilcher Individual Corporate Director Apr 1, 2014
Robert Cataldo Individual Corporate Director Jul 1, 2017
Nancy L Kasparek Individual Corporate Director Apr 1, 2014
Christopher D Dewolf Individual Corporate Director Apr 1, 2014
Mercycare Service Corporation Organization, Cedar Rapids, IA Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2008 100%
Albert P Ruffalo Individual Corporate Director Oct 1, 2009
Sharon Kerrigan Individual Corporate Director Jul 1, 2017
Barrie W Ernst Individual Corporate Director Apr 1, 2014
Barbara Allison Knapp Individual Corporate Director Oct 1, 2009
Rupak H Patel Individual Corporate Director Oct 1, 2009
Michele M Busse Individual Corporate Director Oct 1, 2009
Joseph Malas Individual Corporate OfficerExec VP & Cfo Mar 30, 2026
W-2 Managing EmployeeExec VP & Cfo Mar 30, 2026 100%
Operational/Managerial ControlExec VP & Cfo Mar 30, 2026 100%
Charles a Rohde Individual Corporate Director Oct 1, 2009
John-Paul E Besong Individual Corporate Director Apr 1, 2014
Mary K Quass Individual Corporate Director Jul 1, 2017

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Terrace Glen VillageMarion, IA, CCN 165625 Skilled nursing facility Adp of the SNF Nov 1, 2024
Hallmar VillageCedar Rapids, IA, CCN 165798 Skilled nursing facility Operational/Managerial Control (50%)
Adp of the SNF		 Aug 30, 2023
Oct 2, 2025
Mercy Home CareCedar Rapids, IA, CCN 167151 Home health agency Operational/Managerial Control Mar 19, 1962
Hospice of MercyHiawatha, IA, CCN 161512 Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 1, 1989

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 18

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1467639062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-398-6011",
            "fax_number": "319-398-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-398-6011",
            "fax_number": "319-398-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY MEDICAL CENTER",
        "enumeration_date": "2008-01-25",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "319-398-6133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IA",
            "license": "57036H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Inpatient Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.