Active NPI
Mosaic
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
National Provider Identifier
1972655819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- 770042
- Legal business name
- MOSAIC
- Practice address
- 2317 Vine Street
Des Moines, IA 50265-0000 - Phone
- (515) 246-1840
- Fax
- (515) 246-8236
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott Hoffman
- Title
- Senior VP & Chief Financial Officer
- Phone
- (402) 896-3884
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 770042 | IA | Primary |
Addresses
Primary practice location
2317 Vine Street
Des Moines, IA 50265-0000
Mailing address
4980 S 118TH St
Omaha, NE 68137-2220
Phone (402) 896-3884
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0881870 | Medicaid | IA |
National Provider Directory
National Provider Directory- Tax ID family
- Mosaic
Organizations with this tax ID in the same state 13
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Intellectual Disabilities Intermediate Care Facility
- Logan, IA
- NPI 1831246552
-
- Intellectual Disabilities Intermediate Care Facility
- Belmond, IA
- NPI 1831465715
-
- Intellectual Disabilities Intermediate Care Facility
- Nevada, IA
- NPI 1851666820
-
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
- NPI 1881746725
-
- Intellectual Disabilities Intermediate Care Facility
- Pleasant Hill, IA
- NPI 1902540453
-
- Intellectual Disabilities Intermediate Care Facility
- Pleasant Hill, IA
- NPI 1912648411
-
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
- NPI 1922742501
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Osceola, IA
- NPI 1942357546
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Forest City, IA
- NPI 1942575972
-
- Intellectual Disabilities Intermediate Care Facility
- Clarion, IA
- NPI 1952676926
-
- Intellectual Disabilities Intermediate Care Facility
- Des Moines, IA
- NPI 1962554808
-
- Intellectual Disabilities Intermediate Care Facility
- Osceola, IA
- NPI 1972650471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1591833600000",
"number": "1972655819",
"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": "2317 VINE STREET",
"city": "DES MOINES",
"state": "IA",
"postal_code": "502650000",
"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": "770042",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0881870",
"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.