Provider Demographics
NPI:1952327470
Name:MERCY CLINICS, INC.
Entity Type:Organization
Organization Name:MERCY CLINICS, INC.
Other - Org Name:MERCYONE SOUTH DES MOINES FAMILY MEDICINE CLINIC
Other - Org Type:Doing Business As
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:515-322-1496
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:515-643-9400
Mailing Address - Fax:515-643-9405
Practice Address - Street 1:6601 SW 9TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-6138
Practice Address - Country:US
Practice Address - Phone:515-643-9400
Practice Address - Fax:515-643-9405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY CLINICS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-15
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IACD3776OtherRAILROAD MEDICARE
IA0120444Medicaid
IA0120444Medicaid