Organization Active NPI

Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
National Provider Identifier
1881746725
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
770792 Issued in IA
Legal business name
MOSAIC
Practice address
2900 Francis Drive
Des Moines, IA 50310-0000
Phone
(515) 246-1840
Fax
(515) 246-8236
NPI assigned
Jan 18, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Scott Hoffman
Title
Senior VP & Chief Financial Officer
Phone
(402) 896-3884

National Provider Directory

National Provider Directory
Tax ID family
Mosaic99 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 770792 IA Primary

Addresses

NPPES NPI Registry

Primary practice location

2900 Francis Drive
Des Moines, IA 50310-0000

Mailing address

4980 S 118TH St
Omaha, NE 68137-2220
Phone (402) 896-3884

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0881888MedicaidIA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 11, 2020.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1881746725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4980 S 118TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372220",
            "telephone_number": "402-896-3884",
            "fax_number": "402-894-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FRANCIS DRIVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503100000",
            "telephone_number": "515-246-1840",
            "fax_number": "515-246-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "SENIOR VP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "402-896-3884"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IA",
            "license": "770792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0881888",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 11, 2020; 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.