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Organization Active NPI

Mercy Medical Center

Doing business as Mercy Family Counseling, Mercy Psychiatric

  • Psychiatry Physician
  • Cedar Rapids, IA
National Provider Identifier
1700834165
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MERCY MEDICAL CENTER
Doing business as
Mercy Family Counseling, Mercy Psychiatric
Practice address
5264 Council St NE
Cedar Rapids, IA 52402-2471
Phone
(319) 398-6575
Fax
(319) 369-4673
NPI assigned
May 5, 2006
Last updated
Oct 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Authorized official

Name
Timothy L Charles
Title
President and Ceo
Phone
(319) 398-6697

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Psychologist 103T00000X NU
Social Worker 104100000X NU
Marriage & Family Therapist 106H00000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

5264 Council St NE
Cedar Rapids, IA 52402-2471

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 369-4505

Other names 1

  • Mercy Family Counseling, Mercy Psychiatric Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000145 IA Part B Supplier - Clinic/Group Practice 4183535271 Receives reassigned benefits from 392 practitioners
2 other NPIs on this enrollment
Practice locations: North Liberty, IA; Hiawatha, IA; Independence, IA; Manchester, IA; Marion, IA; Marlon, IA; Monticello, IA; Mount Vernon, IA…

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 487

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 487

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538697600000",
    "number": "1700834165",
    "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": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5264 COUNCIL ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022471",
            "telephone_number": "319-398-6575",
            "fax_number": "319-369-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2018-10-05",
        "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": "319-398-6697"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Family Counseling, Mercy Psychiatric",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.