Individual provider Active NPI

Mary Ann Amend, ARNP

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1659312254
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
074072 Issued in IA
Practice address
146 W Dale St Ste 201
Waterloo, IA 50703-1901
Phone
(319) 226-9888
Fax
(319) 226-9889
NPI assigned
Jun 8, 2006
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 074072 IA Primary

Addresses

Primary practice location

146 W Dale St Ste 201
Waterloo, IA 50703-1901

Mailing address

146 W Dale St Ste 201
Waterloo, IA 50703-1901
Phone (319) 226-9888

Other identifiers 1

IdentifierTypeStateIssuer
1659312254MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20051003000071 IA Practitioner - Nurse Practitioner 6800821448 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

146 W Dale St
Suite 201
Waterloo, IA 50703-1901
Phone (319) 226-9888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
074072IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Allen Memorial Hospital Corporation Nurse Practitioner CurrentSince Aug 31, 2017 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jul 19, 2020 Accepting new patients
Allen Memorial Hospital Corporation Current Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

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

51 Unitypoint Way
Ste 100
Marshalltown, IA 50158
Phone (641) 844-6259

146 W Dale St
Ste 101
Waterloo, IA 50703
Phone (319) 233-3351

146 W Dale St
Ste 201
Waterloo, IA 50703
Phone (319) 234-4431

1731 W Ridgeway Ave
Ste 102
Waterloo, IA 50701
Phone (319) 833-5731

1753 W Ridgeway Ave
Ste 107
Waterloo, IA 50701
Phone (319) 833-5907

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

2413 W Ridgeway Ave
Waterloo, IA 50701
Phone (319) 233-0340

Interoperability endpoints

  • Direct secure messaging: mamend117247@direct.unitypoint.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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1659312254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 W DALE ST STE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031901",
            "telephone_number": "319-226-9888",
            "fax_number": "319-226-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W DALE ST STE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031901",
            "telephone_number": "319-226-9888",
            "fax_number": "319-226-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMEND",
        "first_name": "MARY ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "074072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659312254",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.