Healthcare Provider Details

I. General information

NPI: 1801147269
Provider Name (Legal Business Name): NORTH IOWA MERCY CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S CRESCENT DR STE 200
MASON CITY IA
50401-2911
US

IV. Provider business mailing address

1000 4TH ST SW
MASON CITY IA
50401-2800
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-5300
  • Fax: 641-494-5329
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARK C TRAMMEL
Title or Position: VP FINANCE
Credential:
Phone: 641-428-7984