NPIMap

Organization Active NPI

Amana Medical Care, Inc.

  • Urgent Care Clinic/Center
  • Davenport, IA
National Provider Identifier
1306235072
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
AMANA MEDICAL CARE, INC.
Practice address
2162 W Kimberly Rd
Davenport, IA 52806-5368
Phone
(563) 388-7000
Fax
(563) 388-7001
NPI assigned
Jan 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Dr. Moutaz Kotob, PHD
Title
Secretary
Phone
(563) 505-7537

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2162 W Kimberly Rd
Davenport, IA 52806-5368

Mailing address

2162 W Kimberly Rd
Davenport, IA 52806-5368
Phone (563) 388-7000

Other practice location 1

1903 Park Ave Ste 1500
Muscatine, IA 52761-5400
Phone (563) 263-1903

Other names 1

  • Amana Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150630000541 IA Part B Supplier - Clinic/Group Practice 8224340567 Receives reassigned benefits from 5 practitioners
Practice locations: Davenport, IA; Muscatine, IA
O20180328001922 IA DME Supplier - Sports Medicine 8224340567 Practice locations: Davenport, 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
16D1071984Amana Care1903 Park Avenue, Suite 1500, Muscatine, IA 52761Certificate of waiverAug 6, 2027
16D2094641Amana Care2162 W Kimberly Road, Davenport, IA 52806Certificate of waiverApr 20, 2027

National Provider Directory

National Provider Directory

Locations

2162 W Kimberly Rd
Davenport, IA 52806
Phone (563) 388-7000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11922/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1306235072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2162 W KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065368",
            "telephone_number": "563-388-7000",
            "fax_number": "563-388-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2162 W KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065368",
            "telephone_number": "563-388-7000",
            "fax_number": "563-388-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1903 Park Ave Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Muscatine",
            "state": "IA",
            "postal_code": "527615400",
            "country_code": "US",
            "telephone_number": "563-263-1903",
            "fax_number": "563-263-1904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMANA MEDICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-17",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "KOTOB",
        "authorized_official_first_name": "MOUTAZ",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "563-505-7537",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amana Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Amana Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.