Laura J. Amidon, N.P.
Individual provider Active NPI Family Nurse Practitioner · Mount Pulaski, IL
NPI 1508967837 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1508967837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 277000386 (IL)
- Practice address
- 221 N Lafayette St
Mount Pulaski, IL 62548-1231 - Phone
- (217) 792-5375
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Genesis Health System
Practice addresses (Care Compare)
1236 E Rusholme St
150 Mercyone Genesis
Davenport, IA 52803-2433
Phone (563) 421-3990
Hospital & facility affiliations
- Genesis Medical Center-Davenport
- Genesis HLTH System Dba Genesis MDL Ctr-Illini
- Mercyone Clinton Medical Center
- Mercyone Genesis Dewitt Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 34.85 of 100
- Quality
- 21.4
- Improvement activities
- 0
- Cost
- 76.92
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230615000488 | IA | Practitioner - Nurse Practitioner | 3870517675 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-000540 | IL | MD | Nurse Practitioner |
| 277000386 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Genesis Health System | Current |
Accepting new patients | |
| Genesis Health System | Current |
Accepting new patients |
Locations
865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000
1236 E Rusholme St
Ste 150
Davenport, IA 52803
Phone (563) 421-3990
1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160
4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667
400 E Court Ave
Ste 110
Des Moines, IA 50309
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209-000540 | IL | |
| Family Nurse Practitioner | 363LF0000X | 277000386 | IL | Yes |
Addresses
Primary practice location
221 N Lafayette St
Mount Pulaski, IL 62548-1231
Mailing address
221 N Lafayette St
Mount Pulaski, IL 62548-1231
Phone (217) 792-5375
Other names
- Laura J. Hansen
Other providers in Mount Pulaski, IL
All providers in Mount Pulaski, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.