Active NPI
Midwest Cardiovascular Research Foundation
- Cardiovascular Disease Physician
- Davenport, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- MIDWEST CARDIOVASCULAR RESEARCH FOUNDATION
- Practice address
- 630 E 4TH St Ste a
Davenport, IA 52801-1713 - Phone
- (563) 324-2828
- NPI assigned
- Mar 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nicolas Shammas, MD
- Title
- Owner
- Phone
- (563) 320-0263
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary | ||
| Medical Specialty Clinic/Center | 261QM2500X |
Addresses
Primary practice location
630 E 4TH St Ste a
Davenport, IA 52801-1713
Mailing address
PO Box 850
Moline, IL 61266-0850
Phone (309) 762-9711
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2110876 | Midwest Cardiovascular Research Foundation | Certificate of waiver | Mar 24, 2028 |
National Provider Directory
National Provider DirectoryLocations
630 E 4th St
Ste A
Davenport, IA 52801
Phone (563) 324-2828
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Interventional Cardiology Physician
- Davenport, IA
- NPI 1922087857
-
- Registered Dietitian
- Davenport, IA
- NPI 1114592672
-
- Acute Care Nurse Practitioner
- Davenport, IA
- NPI 1104936087
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1614902400000",
"number": "1891380432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850",
"city": "MOLINE",
"state": "IL",
"postal_code": "612660850",
"telephone_number": "309-762-9711",
"fax_number": "309-764-0553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 E 4TH ST STE A",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528011713",
"telephone_number": "563-324-2828"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDWEST CARDIOVASCULAR RESEARCH FOUNDATION",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-05",
"last_updated": "2021-03-05",
"certification_date": "2021-03-05",
"status": "A",
"authorized_official_last_name": "SHAMMAS",
"authorized_official_first_name": "NICOLAS",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "563-320-0263",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.