The Village Clinic, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

THE VILLAGE CLINIC, LLC

Practice address

2107 E 12TH St
Davenport, IA 52803-3706

Phone

(563) 362-3312

Fax

(563) 204-1179

NPI assigned

Aug 1, 2024

Last updated

Feb 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda M Disch, NPNPI 1932786837

Title

Owner/Nurse Practitioner

Phone

(563) 499-0437

Specialties & licenses 1

Addresses

Other names 2

• Amanda Disch, ARNP Other name
• The Village Clinic Other name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

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.

• Amanda Disch, ARNP

  • Family Nurse Practitioner
  • Davenport, IA
  • NPI 1932786837
  Medicare reassignment NPD Authorized official
• Sarah A Jauron, ARNP

  • Family Nurse Practitioner
  • Davenport, IA
  • NPI 1700156759
  Medicare reassignment NPD
• Beverly A Benmoussa, NP

  • Family Nurse Practitioner
  • Davenport, IA
  • NPI 1568886992
  NPD

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1508695032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 E 12TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528033706",
            "telephone_number": "563-286-0743",
            "fax_number": "563-204-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 E 12TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528033706",
            "telephone_number": "563-362-3312",
            "fax_number": "563-204-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VILLAGE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "DISCH",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "563-499-0437",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amanda Disch, ARNP",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Village Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Primary Care Nurse Practitioner in Davenport, IA
• Providers in Davenport, IA by specialty
• Primary Care Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.