Provider Demographics
NPI:1518687532
Name:MERCY MEDICAL CENTER - NEWTON
Entity Type:Organization
Organization Name:MERCY MEDICAL CENTER - NEWTON
Other - Org Name:MERCYONE NEWTON CANCER CARE APP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-791-4354
Mailing Address - Street 1:204 N 4TH AVE E
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3135
Mailing Address - Country:US
Mailing Address - Phone:641-792-1273
Mailing Address - Fax:
Practice Address - Street 1:204 N 4TH AVE E
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3135
Practice Address - Country:US
Practice Address - Phone:641-792-1273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY MEDICAL CENTER - NEWTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-30
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty