Healthcare Provider Details

I. General information

NPI: 1164602553
Provider Name (Legal Business Name): MERCY CLINICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 1ST ST STE 2200
ANKENY IA
50021-2077
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-9000
  • Fax: 515-643-7509
Mailing address:
  • Phone: 515-643-9000
  • Fax: 515-643-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHARON PHILLIPS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 515-358-6960