# COVENANT MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MercyOne Medical Group Northeast Iowa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548288160
- **Authorized official:** TIMOTHY HUBER (CONTROLLER)
- **Authorized official phone:** (319) 272-7607

## Contact information

- **Practice address:** 3421 W 9TH ST, WATERLOO, IA 50702-5401
- **Practice address phone:** (319) 272-7303
- **Practice address fax:** (319) 272-7318
- **Mailing address:** 3421 W 9TH ST, WATERLOO, IA 50702-5401
- **Mailing address phone:** (319) 272-7304
- **Mailing address fax:** (319) 272-7318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | 1878 | IA | Yes |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 231H00000X | Audiologist | — | NULL | — |
| 231H00000X | Audiologist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 12/02/2025