NPIMap

Organization Active NPI

Mercy Physician Associates, Inc

Doing business as Mercycare Prarie Creek Urgent Care

  • Family Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1619422748
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY PHYSICIAN ASSOCIATES, INC
Doing business as
Mercycare Prarie Creek Urgent Care
Practice address
777 76TH Ave Dr SW
Cedar Rapids, IA 52404
Phone
(319) 558-0352
Fax
(319) 558-0353
NPI assigned
Aug 18, 2016
Last updated
Aug 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Timothy Charles
Title
President and Ceo
Phone
(319) 329-6697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

777 76TH Ave Dr SW
Cedar Rapids, IA 52404

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 558-0352

Other names 1

  • Mercycare Prarie Creek Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000805 IA Part B Supplier - Clinic/Group Practice 1355242496 Receives reassigned benefits from 135 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Central City, IA; Cedard Rapids, IA; Hiawatha, IA; Manchester, IA; Marengo, IA; Marion, IA; Monticello, IA; Mt Vernon, IA…

Other NPIs on the same Medicare enrollment 29

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

View all 29

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1619422748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061824",
            "telephone_number": "319-558-0352",
            "fax_number": "319-558-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 76TH AVE DR SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52404",
            "telephone_number": "319-558-0352",
            "fax_number": "319-558-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY PHYSICIAN ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "319-329-6697"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercycare Prarie Creek Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.