Individual provider Active NPI

Nicole Noelle Matthys, ARNP

  • Family Nurse Practitioner
  • Davenport, IA
National Provider Identifier
1477019511
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A114998 Issued in IA
Practice address
3009 Sheridan St
Davenport, IA 52803-1137
Phone
(563) 320-6241
NPI assigned
Feb 13, 2019
Last updated
Jun 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A114998 IA Primary

Addresses

Primary practice location

3009 Sheridan St
Davenport, IA 52803-1137

Mailing address

3009 Sheridan St
Davenport, IA 52803-1137
Phone (563) 320-6241

Other names 1

  • Nicole Noelle Stivarius Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address support@quadcitiesintegrativewellness.com Direct Quad Cities Ketamine Clinic
Direct Messaging Address contact@quadcitiesketamine.com Direct Quad Cities Integrative Wellness, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL, OK, CO4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20200306001547 IA Practitioner - Nurse Practitioner 2769810670 Reassigns benefits to 1 organization
I20210401000477 IL Practitioner - Nurse Practitioner 2769810670 Reassigns benefits to 1 organization
I20231220004282 OK Practitioner - Nurse Practitioner 2769810670 Reassigns benefits to 1 organization
I20240805003946 CO Practitioner - Nurse Practitioner 2769810670 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A114998IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Health Network LLC CurrentSince Sep 1, 2021 Accepting new patients
Quad Cities Ketamine Clinic Current Accepting new patients
Signify Health, LLC CurrentSince Nov 11, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Nov 1, 2020 Accepting new patients
Trinity Medical Center Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

7700 E Arapahoe Rd
Ste 220
Centennial, CO 80112
Phone (515) 513-4913

4620 E 53rd St
Ste 200
Davenport, IA 52807
Phone (563) 213-5100

4622 Progress Dr
Ste A
Davenport, IA 52807
Phone (563) 742-5800

4626 Progress Dr
Ste A
Davenport, IA 52807
Phone (563) 386-0850

400 E Court Ave
Ste 110
Des Moines, IA 50309

100 Illinois St
Ste 200
St Charles, IL 60174
Phone (630) 513-5576

10601 S Western Ave
Ste 100
Oklahoma City, OK 73170

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Interoperability endpoints

  • Direct secure messaging: nmatthys247189@uihcdirect.org

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1477019511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 SHERIDAN ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528031137",
            "telephone_number": "563-320-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 SHERIDAN ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528031137",
            "telephone_number": "563-320-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHYS",
        "first_name": "NICOLE",
        "middle_name": "NOELLE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A114998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "support@quadcitiesintegrativewellness.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Quad Cities Ketamine Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "4622 Progress Dr Ste A",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528073426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@quadcitiesketamine.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Quad Cities Integrative Wellness, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "4622 Progress Dr Ste A",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528073426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "STIVARIUS",
            "middle_name": "NOELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.