NPIMap

Organization Active NPI

Mercy Services Iowa City, Inc.

  • Primary Care Clinic/Center
  • Tipton, IA
National Provider Identifier
1487791059
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MERCY SERVICES IOWA CITY, INC.
Practice address
56 Cedar St
Tipton, IA 52772-1705
Phone
(563) 886-2195
Fax
(563) 886-3268
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Michele Ann Bogs
Title
Executive Assistant
Phone
(319) 339-3540

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

56 Cedar St
Tipton, IA 52772-1705

Mailing address

500 E Market St
Iowa City, IA 52245-2633
Phone (319) 339-3540

Other identifiers 1

IdentifierTypeStateIssuer
0281584MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040129000617 IA Part B Supplier - Clinic/Group Practice 2860395688 Receives reassigned benefits from 18 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coralville, IA; Williamsburg, IA; West Liberty, IA; West Branch, IA; Tipton, IA; Solon, IA; Muscatine, IA; Kalona, IA…

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1487791059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E MARKET ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452633",
            "telephone_number": "319-339-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 CEDAR ST",
            "city": "TIPTON",
            "state": "IA",
            "postal_code": "527721705",
            "telephone_number": "563-886-2195",
            "fax_number": "563-886-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY SERVICES IOWA CITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "BOGS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "319-339-3540"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0281584",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.