Organization Active NPI

Amana Family Practice Clinic, PC

  • Family Medicine Physician
  • Amana, IA
National Provider Identifier
1073677019
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AMANA FAMILY PRACTICE CLINIC, PC
Practice address
505 39TH Ave
Amana, IA 52203-8229
Phone
(319) 622-3231
Fax
(319) 622-3077
NPI assigned
Dec 21, 2006
Last updated
Nov 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erica L Zimmerman
Title
Office Manager
Phone
(319) 622-3231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

505 39TH Ave
Amana, IA 52203-8229

Mailing address

505 39TH Ave
PO Box 207
Amana, IA 52203-8229
Phone (319) 622-3231

Other identifiers 1

IdentifierTypeStateIssuer
CJ8590OtherIARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040401001334 IA Part B Supplier - Clinic/Group Practice 1658363270 Receives reassigned benefits from 5 practitioners
Practice locations: Amana, IA
O20100930068928 IA DME Supplier - Physician - Family Practice 1658363270 Practice locations: Amana, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0386379Amana Family Practice Clinic PC505 39TH Ave PO Box 207, Amana, IA 52203Provider-performed microscopyDec 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1073677019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 39TH AVE",
            "address_2": "PO BOX 207",
            "city": "AMANA",
            "state": "IA",
            "postal_code": "522038229",
            "telephone_number": "319-622-3231",
            "fax_number": "319-622-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 39TH AVE",
            "city": "AMANA",
            "state": "IA",
            "postal_code": "522038229",
            "telephone_number": "319-622-3231",
            "fax_number": "319-622-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANA FAMILY PRACTICE CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "319-622-3231"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ8590",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amana, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.