Healthcare Provider Details

I. General information

NPI: 1497366231
Provider Name (Legal Business Name): OBRIA MEDICAL CLINIC OF AMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 GOLDEN ASPEN DR STE 101
AMES IA
50010-8098
US

IV. Provider business mailing address

1615 GOLDEN ASPEN DR STE 101
AMES IA
50010-8098
US

V. Phone/Fax

Practice location:
  • Phone: 515-620-5892
  • Fax: 515-620-5893
Mailing address:
  • Phone: 515-620-5892
  • Fax: 515-620-5893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAMELA J ADAMS
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 319-850-2123