MEDICARE: MERCY CLINICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133V00000X	Registered Dietitian
2	207R00000X	Internal Medicine Physician
3	2080A0000X	Pediatric Adolescent Medicine Physician
4	261QP2300X	Primary Care Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CD3776	OTHER	IA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194745752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY CLINICS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-643-0833
Fax Number	:	515-643-0933

Provider Business Practice Location Address
First Line	:	1350 DES MOINES ST STE 110
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50309-5507
Country	:	US
Telephone Number	:	515-643-0833
Fax Number	:	515-643-0933

Authorized Official
Title or Position	:	COO
Name	:	BRADLEY WHIPPLE
Credential	:
Telephone Number	:	515-358-6956

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	10/11/2024

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Directions to “MERCY CLINICS, INC. ” Practice Location

Language	Start Address	Practice Location

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