Individual provider Active NPI

Nicole Fedele, ARNP

  • Acute Care Nurse Practitioner
  • Bettendorf, IA
National Provider Identifier
1407257488
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
H096495 Issued in IA
Practice address
1351 Kimberly Rd Ste 100
Bettendorf, IA 52722-4193
Phone
(563) 355-7733
Fax
(563) 355-9077
NPI assigned
Sep 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209.011784 IL
Acute Care Nurse Practitioner 363LA2100X H096495 IA Primary

Addresses

Primary practice location

1351 Kimberly Rd Ste 100
Bettendorf, IA 52722-4193

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (563) 355-7733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150106001851 IL Practitioner - Nurse Practitioner 7113240755 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
H096495IAMDAcute Care Nurse Practitioner
209.011784ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Quad Cities, LLC CurrentSince Feb 1, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

3682 Utica Ridge Rd
Bettendorf, IA 52722
Phone (309) 757-7780

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

615 35th Ave
Moline, IL 61265
Phone (309) 757-7780

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

Interoperability endpoints

  • Direct secure messaging: nfedele218600@direct.unitypoint.org
  • Direct secure messaging: nicole.fedele@direct.genesishealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1407257488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "563-355-7733",
            "fax_number": "563-355-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 KIMBERLY RD STE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224193",
            "telephone_number": "563-355-7733",
            "fax_number": "563-355-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDELE",
        "first_name": "NICOLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.011784",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "H096495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.