Individual provider Active NPI

Heather Bruss, FNP-C

  • Nurse Practitioner
  • Moline, IL
National Provider Identifier
1639755747
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209022824 Issued in IL
Practice address
550 30TH Ave Ste 12
Moline, IL 61265-5975
Phone
(309) 736-5568
Fax
(309) 736-1152
NPI assigned
Mar 19, 2021
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A162114 IA
Internal Medicine Physician 207R00000X 209022824 IL
Nurse Practitioner 363L00000X 209022824 IL Primary

Addresses

Primary practice location

550 30TH Ave Ste 12
Moline, IL 61265-5975

Mailing address

550 30TH Ave Ste 12
Moline, IL 61265-5975
Phone (309) 736-5568

Other names 1

  • Heather Whiting Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210421000969 IL Practitioner - Nurse Practitioner 5991113425 Reassigns benefits to 1 organization
I20210624000723 IA Practitioner - Nurse Practitioner 5991113425 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209022824ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Health Services of Eastern Iowa Inc CurrentSince Dec 18, 2023 Accepting new patients
Thomas D Ade MD PLLC CurrentSince May 24, 2024 Accepting new patients

Locations

2635 Lincoln Way
Ste A
Clinton, IA 52732
Phone (563) 241-1328

229 S Main St
Maquoketa, IA 52060
Phone (563) 352-3749

550 30th Ave
Ste 12
Moline, IL 61265
Phone (309) 736-5568

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, 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": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1639755747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 30TH AVE STE 12",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612655975",
            "telephone_number": "309-736-5568",
            "fax_number": "309-736-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 30TH AVE STE 12",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612655975",
            "telephone_number": "309-736-5568",
            "fax_number": "309-736-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSS",
        "first_name": "HEATHER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A162114",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "209022824",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WHITING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.