MERCY PROFESSIONAL PRACTICE ASSOCIATES, INC.


Address: 1111 6th Ave, Main 3, Des Moines, IA 50314-2610
Phone: 5156438677

MERCY PROFESSIONAL PRACTICE ASSOCIATES, INC. (NPI# 1922014356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922014356
Entity Type Organization
Organization Name MERCY PROFESSIONAL PRACTICE ASSOCIATES, INC.
Other Organization Name MERCY PEDIATRIC INTENSIVISTS
Practice Address 1111 6th Ave
Main 3
Des Moines
IA 50314-2610
Mailing Address Po Box 4925
Des Moines
IA 50305-4925
Practice Telephone 5156438677
Practice Fax Number 5156438966
Mailing Telephone 5156438677
Mailing Fax Number 5156438966
Enumeration Date 2006-07-31
Last Update Date 2012-04-09
Authorized Official Name DAVID VELLINGA (PRESIDENT/CEO)
Authorized Official Telephone 5152474278
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IA 0173187 05

Other Provider/Organization Names

Other Name Type Code
Mercy Pediatric Intensivists Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1902286073 Mercy Professional Practice Associates, Inc. Hospice Care, Community Based 204 N 4th Ave E, Newton, IA 50208-3135 2015-06-04
1649650706 Mercy Professional Practice Associates, Inc. Physical Therapist 204 N 4th Ave E, Newton, IA 50208-3135 2015-06-04
1659751717 Mercy Professional Practice Associates, Inc. Surgery 300 N 4th Ave E, Suite D, Newton, IA 50208-3155 2015-06-04
1487034542 Mercy Professional Practice Associates, Inc. Emergency Medicine 204 N 4th Ave E, Newton, IA 50208-3135 2015-06-04
1215317581 Mercy Professional Practice Associates, Inc. Home Health 204 N 4th Ave E, Newton, IA 50208-3135 2015-06-02
1235499765 Mercy Professional Practice Associates, Inc. Pediatrics 411 Laurel St, Suite: 3310, Des Moines, IA 50314-3017 2012-05-17
1467720771 Mercy Professional Practice Associates, Inc. Surgery 1111 6th Ave, Suite: B1, Des Moines, IA 50314-2613 2011-12-01
1124032016 Mercy Professional Practice Associates, Inc. Hospitalist 1111 6th Ave, Main 3, Des Moines, IA 50314-2610 2006-07-28
1437173812 Mercy Professional Practice Associates, Inc. Pediatrics 1111 6th Ave, Main 3, Des Moines, IA 50314-2610 2006-07-27
1215959481 Mercy Professional Practice Associates, Inc. Clinic/Center 411 Laurel St, Suite 3262, Des Moines, IA 50314-3017 2006-07-24

Office Location

Street Address 1111 6TH AVE
MAIN 3
City DES MOINES
State IA
Zip Code 50314-2610

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790785004 Keven Odell Cutler Emergency Medicine 1111 6th Ave, Emergency Dept, Des Moines, IA 50314-2613 2005-07-28
1508470014 Tammie Jordan Pharmacist 1111 6th Ave, Des Moines, IA 50314-2613 2020-09-02
1942812243 Samantha Marie Ulsh Nurse Practitioner 1111 6th Ave, Des Moines, IA 50314-2613 2020-08-18
1962020677 Jordyn Hauser Dietitian, Registered 1111 6th Ave, Des Moines, IA 50314-2613 2020-07-09
1659996528 Doh Joon Park Internal Medicine 1111 6th Ave, Des Moines, IA 50314-2613 2020-06-16
1508481623 Maianh T Tran Surgery 1111 6th Ave, Des Moines, IA 50314-2613 2020-06-15
1083239081 Max E Reiche Family Medicine 1111 6th Ave, Des Moines, IA 50314-2613 2020-06-15
1760007488 Obidike P Nwadike Family Medicine 1111 6th Ave, Des Moines, IA 50314-2613 2020-06-09
1154945970 Jason C Wang Internal Medicine 1111 6th Ave, Des Moines, IA 50314-2613 2020-06-08
1588288435 Elliot M Deblieck Family Medicine 1111 6th Ave, Des Moines, IA 50314-2613 2020-06-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982266979 Dental Connections, Inc. Dentist 1111 9th Street, Suite 190, Des Moines, IA 50314 2019-07-01
1760910723 Kelsey Taylor Social Worker 1761 Hickman Rd, Des Moines, IA 50314 2017-06-02
1184085672 Allison J Robbins Counselor 1063 14th Place, Suite A, Des Moines, IA 50314 2016-03-11
1083081715 Taylor Witzel Specialist/Technologist 450 Laurel Street, Des Moines, IA 50314 2015-08-28
1376893933 Caring Hearts LLC In Home Supportive Care 1620 Pleasant, #245, Des Moines, IA 50314 2012-09-11
1104117522 Akinbode Solomon Egbelakin Pediatrics 1111 6th Ave # Main3, Des Moines, IA 50314 2011-04-20
1447488325 Abdelaziz Elhaddad Internal Medicine 95 University Avenue, Suite 1, Des Moines, IA 50314 2009-06-30
1356584080 Tara Michelle Graff Internal Medicine 411 Laurel Street Suite A300, Des Moines, IA 50314 2009-04-10
1700068517 Planned Parenthood of The Heartland Family Medicine 123 Clark Street, Des Moines, IA 50314 2007-12-04
1790903235 Christy J. Meyer Counselor 1063 14th Place, Suite A, Des Moines, IA 50314 2007-04-22
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Taxonomy Information

Taxonomy Code 2080P0203X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Critical Care Medicine

Taxonomy Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics)

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912247818 Mercy Clinics, Inc Pediatrics 1111 6th Ave, Main 3, Des Moines, IA 50314-2613 2013-03-01
1184980278 Morgan Leigh Grundstad Pediatrics 1111 6th Ave, Des Moines, IA 50314-2611 2012-04-03
1265500383 Tracy L Ekhardt Pediatrics 1200 Pleasant St, Des Moines, IA 50309-1406 2006-11-30
1407838618 Judy R Walker Pediatrics 1200 Pleasant St, Blank Childrens Hospital, Des Moines, IA 50309-1406 2005-11-15
1891780730 Judith Heggen Pediatrics 1111 6th Ave, Main 3, Des Moines, IA 50314-2613 2005-09-16
1255325130 Karen J Gerdes Pediatrics 1200 Pleasant St, Blank Children's Hospital, Des Moines, IA 50309-1406 2005-09-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1346760832 Christopher David Monson Pediatrics 200 Hawkins Dr Dept Peds, Iowa City, IA 52242-1009 2017-06-26
1134376809 Christina Luz Lopez Cifra Pediatrics 200 Hawkins Dr, Iowa City, IA 52242-1009 2008-08-25
1043474505 Cody R. Tigges Pediatrics 200 Hawkins Dr, 7770-kjpp, Iowa City, IA 52242-1009 2008-07-14
1922275122 Melinda Coro Pediatrics 200 Hawkins Dr, Iowa City, IA 52242-1009 2008-05-15
1720265044 Shilpa Chandrappa Balikai Pediatrics 200 Hawkins Dr, Department of Pediatric Critical Care, Iowa City, IA 52242-1009 2008-01-29
1467661561 Dewey K. Clark Pediatrics 200 Hawkins Dr, Iowa City, IA 52242-1009 2007-05-22
1205040813 Sameer Shantaram Kamath Pediatrics 200 Hawkins Dr, Iowa City, IA 52242-1009 2007-05-10
1649252859 Cheryl L Standing Pediatrics 1610 W Townline St, Creston, IA 50801-1066 2005-11-15
1790770147 Jeffrey H Burzynski Pediatrics 200 Hawkins Dr, University of Iowa Hospitals & Clinics, Iowa City, IA 52242-1009 2005-09-13
1487655049 John J Meehan Pediatrics 200 Hawkins Dr, Iowa City, IA 52242-1009 2005-08-04
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Competitor

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City DES MOINES
Zip Code 50314

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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