NPIMap

Organization Active NPI

Mercy Clinics, Inc

Doing business as MercyOne Beaverdale Family Medicine Clinic

  • Primary Care Clinic/Center
  • Des Moines, IA
National Provider Identifier
1710903364
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MERCY CLINICS, INC
Doing business as
MercyOne Beaverdale Family Medicine Clinic
Practice address
1750 48TH St
Suite 1
Des Moines, IA 50310-1988
Phone
(515) 271-6333
Fax
(515) 271-6175
NPI assigned
Jul 15, 2006
Last updated
Oct 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Bradley Whipple
Title
Chief Operating Officer
Phone
(515) 358-6956

Specialties & licenses 1

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

Addresses

Primary practice location

1750 48TH St
Suite 1
Des Moines, IA 50310-1988

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 271-6333

Other identifiers 2

IdentifierTypeStateIssuer
CD3776OtherIARAILROAD MEDICARE
0114983MedicaidIA

Other names 1

  • MercyOne Beaverdale Family Medicine 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

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1710903364",
    "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": "515-271-6333",
            "fax_number": "515-271-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 48TH ST",
            "address_2": "SUITE 1",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503101988",
            "telephone_number": "515-271-6333",
            "fax_number": "515-271-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "WHIPPLE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "515-358-6956"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD3776",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114983",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MercyOne Beaverdale Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.