Provider Demographics
NPI:1063438729
Name:MERCY CLINICS, INC
Entity type:Organization
Organization Name:MERCY CLINICS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-358-6956
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-358-7271
Mailing Address - Fax:515-358-7294
Practice Address - Street 1:1601 NW 114TH ST
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7007
Practice Address - Country:US
Practice Address - Phone:515-222-7000
Practice Address - Fax:515-222-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0427468Medicaid
IACD3776OtherRAILROAD MEDICARE
IA0273052Medicaid
IA1236174Medicaid
IA0210005Medicaid
IA0236174Medicaid
IA0274811Medicaid
IA0451906Medicaid
IA0251983Medicaid
IA0235762Medicaid
IA0450908Medicaid
IA29003Medicare ID - Type UnspecifiedGROUP
IAI3202Medicare ID - Type UnspecifiedGROUP
IA25198Medicare ID - Type UnspecifiedGROUP
IA0427468Medicaid
IA51654Medicare ID - Type UnspecifiedGROUP
IA0251983Medicaid
IA0210005Medicaid
IA0235762Medicaid
IA0236174Medicaid