NPIMap

Organization Active NPI

Covenant Medical Center Inc

Doing business as MercyOne Waterloo Medical Center

  • General Acute Care Hospital
  • Waterloo, IA
National Provider Identifier
1700827896
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
070137H Issued in IA
Legal business name
COVENANT MEDICAL CENTER INC
Doing business as
MercyOne Waterloo Medical Center
Practice address
3421 W 9TH St
Waterloo, IA 50702-5401
Phone
(319) 272-8000
Fax
(319) 272-7597
NPI assigned
Jun 9, 2006
Last updated
Jun 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Timothy Huber
Title
Controller
Phone
(319) 272-7607

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 070137H IA Primary
Ambulance 341600000X

Addresses

Primary practice location

3421 W 9TH St
Waterloo, IA 50702-5401

Mailing address

3421 W 9TH St
Waterloo, IA 50702-5401
Phone (319) 272-7600

Other names 1

  • MercyOne Waterloo Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocuentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090519000022 IA Part A Provider - Hospital 0244148732

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700827896. Details of each certification follow.

Hospital certification: CCN 160067

Legal name
COVENANT MEDICAL CENTER INC
Doing business as
MERCYONE WATERLOO MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 29, 2016
Beds
423
Ownership / control type
Church
Organization structure
CorporationNon-profit
Enrollment address
3421 W 9TH St
Waterloo, IA 50702-5401
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercyone Waterloo Medical CenterCCN 160067 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Lee O Fagre MD15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

200 E Ridgeway Ave
Ste 100
Waterloo, IA 50702

3421 W 9th St
Ste 4600
Waterloo, IA 50702

3421 W 9th St
Ste G4500
Waterloo, IA 50702
Phone (319) 233-8865

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Lora L Dinsdale Individual W-2 Managing EmployeeDirector, Corporate Compliance Mar 2, 1987
Ryan D Meyer Individual Corporate OfficerCoo Jan 1, 2023
W-2 Managing EmployeeCoo Jan 1, 2023
Timothy J Huber Individual Corporate OfficerTreasurer Apr 10, 2017
W-2 Managing EmployeeController Dec 7, 1987
Wheaton Franciscan Healthcare - Iowa Inc Organization, Waterloo, IA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 20, 2006 100%
Sheila Gifford Individual Corporate OfficerSecretary Aug 1, 2025
Mercy Health Network Inc Organization, Clive, IA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2016 100%
Rachelle a Makinde Individual Corporate OfficerVice-Chair Jan 1, 2025
Corporate DirectorBoard Member Jan 1, 2022
Sandra Lynn Benak Individual Corporate DirectorBoard Member Jan 1, 2021
Kurt a Andersen Individual Corporate DirectorBoard Member Jan 1, 2025
Nancy K Kertz Individual Corporate DirectorBoard Member Jan 1, 2025
Bryan Burton Individual Corporate DirectorBoard Member Jan 1, 2025
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest May 1, 2016 100%
David W Deaver Individual Corporate OfficerChair Jan 1, 2025
Corporate DirectorBoard Member Apr 2, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 215

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

View all 215

Practitioners & affiliated clinicians

Practitioners 57

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 57

Affiliated clinicians 450

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

View all 450

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1700827896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-7600",
            "fax_number": "319-272-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-8000",
            "fax_number": "319-272-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "HUBER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "319-272-7607"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IA",
            "license": "070137H",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocuentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.11383.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MercyOne Waterloo Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.