NPIMap

Organization Active NPI

Mental Health Institute

  • Psychiatric Hospital
  • Independence, IA
National Provider Identifier
1841279239
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
100068H Issued in IA
Legal business name
MENTAL HEALTH INSTITUTE
Practice address
2277 Iowa Ave
Independence, IA 50644-9106
Phone
(319) 334-2583
Fax
(319) 334-5252
NPI assigned
Jan 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Authorized official

Name
Dr. Bhasker Dave, M.D.NPI 1679684641
Title
Superintendant
Phone
(319) 334-2583

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 100068H IA Primary

Addresses

Primary practice location

2277 Iowa Ave
Independence, IA 50644-9106

Mailing address

2277 Iowa Ave
Independence, IA 50644-9106
Phone (319) 334-2583

Other identifiers 2

IdentifierTypeStateIssuer
0640037MedicaidIA
64003OtherIABL. CR. BL. SH. PROV. NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210826003045 IA Part A Provider - Hospital 5496646978 Practice locations: Independence, IA

Hospital certification: CCN 164003

Legal name
MENTAL HEALTH INSTITUTE
Doing business as
MENTAL HEALTH INSTITUTE
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Mar 23, 2016
Beds
130
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
2277 Iowa Ave
Independence, IA 50644-9106
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mental Health InstituteCCN 164003
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Mental Health Institute Organization, Independence, IA For-profit 5% Or Greater Direct Ownership Interest Jul 23, 2010 100%
Bhasker J Dave Individual Corporate DirectorSuperintendant May 1, 1984 100%
W-2 Managing EmployeeSuperintendant Jul 22, 2010 100%
Kevin Jimmerson Individual W-2 Managing EmployeeBusiness Manager Oct 4, 2010 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1841279239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583",
            "fax_number": "319-334-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583",
            "fax_number": "319-334-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "DAVE",
        "authorized_official_first_name": "BHASKER",
        "authorized_official_title_or_position": "SUPERINTENDANT",
        "authorized_official_telephone_number": "319-334-2583",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "IA",
            "license": "100068H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0640037",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BL. CR. BL. SH. PROV. NO.",
            "identifier": "64003",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, IA

Sources for this page

Verify at the official NPI Registry.