# MERCY PHYSICIAN ASSOCIATES, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MERCY PHYSICIAN ASSOCIATES, INC
- **Other names:** Merycare Prarie Creek
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255886388
- **Legal business name:** MERCY PHYSICIAN ASSOCIATES, INC
- **Authorized official:** GREGORY DEWOLF (INTERIM PRESIDENT & CEO)
- **Authorized official phone:** (319) 398-6101

## Contact information

- **Practice address:** 777 76TH AVENUE DR SW, CEDAR RAPIDS, IA 52404-7006
- **Practice address phone:** (319) 558-0350
- **Practice address fax:** (319) 558-0351
- **Mailing address:** PO BOX 1824, CEDAR RAPIDS, IA 52406-1824
- **Mailing address phone:** (319) 558-0350
- **Mailing address fax:** (319) 558-0351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 08/18/2016
- **Last updated:** 06/15/2026