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Organization Active NPI

Alegent Health Bergan Mercy Health System

  • Psychiatric Residential Treatment Facility
  • Glenwood, IA
National Provider Identifier
1871665372
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
65PM28 Issued in IA
Legal business name
ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM
Practice address
359 Indian Hills Dr
Glenwood, IA 51534-1953
Phone
(712) 527-2049
NPI assigned
Nov 14, 2006
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Evert Kuiper
Title
Ceo
Phone
(402) 343-4420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 65PM28 IA Primary

Addresses

Primary practice location

359 Indian Hills Dr
Glenwood, IA 51534-1953

Mailing address

PO Box 1C
Council Bluffs, IA 51502-3001
Phone (402) 527-2049

Other practice location 1

800 Mercy Dr
Council Bluffs, IA 51503-3128
Phone (402) 527-2049

Other identifiers 1

IdentifierTypeStateIssuer
0010090MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Alegent Health Bergan Mercy15 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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1871665372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1C",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515023001",
            "telephone_number": "402-527-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 INDIAN HILLS DR",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341953",
            "telephone_number": "712-527-2049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Mercy Dr",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515033128",
            "country_code": "US",
            "telephone_number": "402-527-2049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "EVERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-343-4420"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "IA",
            "license": "65PM28",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010090",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.