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MERCY CARE MANAGEMENT INC NPI 1306042890


NPI Information

NPI: 1306042890
Provider Name: MERCY CARE MANAGEMENT, INC

Doing Business As: MERCY CARE SOUTH

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 16D2209081

Address:
2815 EDGEWOOD RD SW
CEDAR RAPIDS, IA
ZIP 52404
Phone: (319) 369-4798
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MERCY CARE MANAGEMENT, INC is a family medicine in Cedar Rapids, IA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MERCY CARE MANAGEMENT, INC NPI is 1306042890. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mercy Care South.

The provider's business location address is:

2815 EDGEWOOD RD SW
CEDAR RAPIDS, IA
ZIP 52404-258
Phone: (319) 369-4798

The provider's authorized official is Timothy L Charles .
The authorized official title is President And Ceo and has the following contact phone number (319) 398-6697.

The CLIA number assigned to this NPI record is 16D2209081 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2007 and was last updated on 11/1/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyNo
2207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10794263MEDICAIDIOWA
20794255MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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