NPIMap

Organization Active NPI

Catholic Health Initiatives-Iowa Corp

  • Diagnostic Radiology Physician
  • Clive, IA
National Provider Identifier
1720145840
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CATHOLIC HEALTH INITIATIVES-IOWA CORP
Practice address
1601 NW 114TH St
Suite 128
Clive, IA 50325-7007
Phone
(515) 222-7550
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Kurt Andersen
Title
President
Phone
(515) 358-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1601 NW 114TH St
Suite 128
Clive, IA 50325-7007

Mailing address

1601 NW 114TH St Ste 128
Clive, IA 50325-7036
Phone (515) 222-7555

Other identifiers 2

IdentifierTypeStateIssuer
33632OtherIAWELLMARK BLUE CROSS
3255349MedicaidIA

Other names 1

  • MercyOne Clive Imaging Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/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
O20041110000606 IA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5698683142 Practice locations: Clive, IA

Other NPIs with the same Medicare PAC ID 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1087340Mercyone Clive Imaging1601 NW 114TH Street, Suite 128, Clive, IA 50325Certificate of waiverDec 18, 2026

National Provider Directory

National Provider Directory
Tax ID family
Catholic Health Iowa Corp15 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

1601 NW 114th St
Ste 128
Des Moines, IA 50325
Phone (515) 222-7550

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercyone Centerville Medical CenterCenterville, IA, CCN 161377 Hospital 5% Or Greater Indirect Ownership Interest (100%) Sep 1, 2022
Mercyone Centerville Medical CenterCenterville, IA, CCN 16Z377 Hospital 5% Or Greater Indirect Ownership Interest (100%) Sep 1, 2022
Mercyone Newton Medical CenterNewton, IA, CCN 160032 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Mercyone Newton Medical Center-Swing BedNewton, IA, CCN 16U032 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022
Mercy Rehabilitation HospitalClive, IA, CCN 163025 Hospital 5% Or Greater Direct Ownership Interest (51%) Apr 26, 2016
Clive Behavioral HealthClive, IA, CCN 164007 Hospital 5% Or Greater Direct Ownership Interest (48%) May 28, 2018
Mercyone Centerville Medical ClinicCenterville, IA, CCN 168533 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2022

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 114

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 114

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1720145840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 NW 114TH ST STE 128",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257036",
            "telephone_number": "515-222-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW 114TH ST",
            "address_2": "SUITE 128",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257007",
            "telephone_number": "515-222-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC HEALTH INITIATIVES-IOWA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-358-9200"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS",
            "identifier": "33632",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3255349",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "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 Clive Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.