Organization Active NPI

Mercy Clinics Inc

  • Primary Care Clinic/Center
  • West Des Moines, IA
National Provider Identifier
1619259876
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MERCY CLINICS INC
Practice address
2501 Westown Pkwy
Suite 1103
West Des Moines, IA 50266-1427
Phone
(515) 440-3484
Fax
(515) 440-0557
NPI assigned
Sep 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Authorized official

Name
David Vellinga
Title
Pres/Ceo
Phone
(515) 247-4278

Specialties & licenses 1

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

Addresses

Primary practice location

2501 Westown Pkwy
Suite 1103
West Des Moines, IA 50266-1427

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 440-3484

Other names 1

  • Mercy Khan Family Medical 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

1601 NW 114th St
Ste 247
Des Moines, IA 50325
Phone (515) 222-7000

Practitioners & affiliated clinicians

Practitioners 2

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": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1619259876",
    "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": "515-440-3484",
            "fax_number": "515-440-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 WESTOWN PKWY",
            "address_2": "SUITE 1103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661427",
            "telephone_number": "515-440-3484",
            "fax_number": "515-440-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "VELLINGA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRES/CEO",
        "authorized_official_telephone_number": "515-247-4278"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Khan Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.