MEDICARE: MERCY SPECIALTY CLINIC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DG7041	OTHER	IA	RR MEDICARE
4	DG7041	OTHER		RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71222	OTHER	IA	WELLMARK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1386832764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY SPECIALTY CLINIC

Provider Business Mailing Address
First Line	:	1410 NORTH 4TH STREET
Second Line	:
City	:	CLINTON
State	:	IA
Zip	:	52732-2940
Country	:	US
Telephone Number	:	563-244-5900
Fax Number	:	563-244-5901

Provider Business Practice Location Address
First Line	:	1410 NORTH 4TH STREET
Second Line	:
City	:	CLINTON
State	:	IA
Zip	:	52732-2940
Country	:	US
Telephone Number	:	563-244-5900
Fax Number	:	563-244-5901

Authorized Official
Title or Position	:	COO/CNO
Name	:	MELLISSA WOOD
Credential	:
Telephone Number	:	563-244-5608

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	03/05/2026

1410 N 4TH ST , SUITE A102
CLINTON, IA
52732-2940

Practice Phone: 563-244-3674
Practice Fax: 563-244-3789