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STONE RIDGE MEDICAL GROUP SC
NPI 1306097894
Family Medicine in East Moline, IL

Active since October 02, 2008CLIA 14D0946584 · Microscopy
306 46TH AVE, EAST MOLINE, IL 61244(309) 796-2329(309) 796-1146 Get Directions Write a Review

NPPES record last updated: October 2, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Stone Ridge Medical Group Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STONE RIDGE MEDICAL GROUP SC (NPI 1306097894) is a healthcare organization registered as a family medicine in East Moline, Illinois and active in the NPI registry since October 2008. The organization holds a CLIA Microscopy certificate valid through May 27, 2028 and lists James Petre, President, as its authorized official.

NPPES Registry Identity

NPI1306097894
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSTONE RIDGE MEDICAL GROUP SC
Location Address306 46TH AVEEast Moline, IL 61244-4281
Mailing Address306 46th AveEast Moline, IL 61244-4281 · (309) 796-2329 · Fax (309) 796-1146
Phone(309) 796-2329
Fax(309) 796-1146
Organization SubpartNo
Authorized OfficialJames PetrePresident · (309) 796-2329
Enumeration DateOctober 2, 2008
✔ NPI 1306097894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IL · 336053231✔ Licensed in IL · 036091695
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 085002304 (IL)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 209000908 (IL)
306 46TH AVE, East Moline, IL 61244
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stone Ridge Medical Group Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Stone Ridge Medical Group Sc, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Nicholas Petre, MD
Family Practice
NPI 1699269308
306 46TH AVE
East Moline, IL 61244
(309) 796-2329
✔ PECOS✔ Accepts Medicare0.1 mi
Courtney Bibo, DNP
Nurse Practitioner
NPI 1679311617
306 46TH AVE
East Moline, IL 61244
(309) 796-2329
✔ PECOS✔ Accepts Medicare0.9 mi
James Petre, MD
Family Practice
NPI 1619973989
306 46TH AVE
East Moline, IL 61244
(309) 796-2329
✔ PECOS✔ Accepts Medicare0.9 mi
Jennifer Wilkinson, APRN
Nurse Practitioner
NPI 1710647870
306 46TH AVE
East Moline, IL 61244
(309) 796-2329
✔ PECOS✔ Accepts Medicare0.9 mi
Kate Stamer, ARNP
Nurse Practitioner
NPI 1871992289
4017 DEVILS GLEN RD
Bettendorf, IA 52722
(563) 332-3400
✔ PECOS✔ Accepts Medicare5.7 mi
Jennifer Hook, FNP-C
Nurse Practitioner
NPI 1033662044
2217 ROCKINGHAM RD
Davenport, IA 52802
(563) 900-8465
✔ PECOS✔ Accepts Medicare8.3 mi
Drew Amador, MD
Family Practice
NPI 1942878186
200 HAWKINS DR
Iowa City, IA 52242
(319) 384-7222
✔ PECOS✔ Accepts Medicare58 mi
Michele Moritz, FNP-BC
Nurse Practitioner
NPI 1710492582
10240 N 43RD AVE STE 3
Glendale, AZ 85302
(480) 931-3156
✔ PECOS✔ Accepts Medicare1,306 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 14D0946584

Stone Ridge Medical Group · East Moline, IL
Active · expires May 27, 2028
CLIA Number14D0946584
Laboratory TypePhysician Office
Certificate Effective DateMay 28, 2026
Certificate Expiration DateMay 27, 2028
Laboratory DirectorJames E. Petre MD
Laboratory Phone(309) 796-2329
Laboratory LocationStone Ridge Medical Group306 46th Ave, East Moline, IL 61244
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stone Ridge Medical Group Sc's NPI number?

The NPI number for Stone Ridge Medical Group Sc is 1306097894. It was assigned to this organization in the NPPES registry on October 2, 2008.

Where is Stone Ridge Medical Group Sc located?

Stone Ridge Medical Group Sc is located at 306 46th Ave, East Moline, IL 61244. The listed phone number is (309) 796-2329.

What is Stone Ridge Medical Group Sc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Stone Ridge Medical Group Sc enrolled in Medicare?

Yes. Stone Ridge Medical Group Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stone Ridge Medical Group Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Stone Ridge Medical Group Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5) and Family Practice (3). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Stone Ridge Medical Group Sc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D0946584) is associated with this NPI, valid through May 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Stone Ridge Medical Group Sc was last updated on October 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.