Organization Active NPI

Genesis Health System

  • Family Medicine Physician
  • Bettendorf, IA
National Provider Identifier
1023112448
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GENESIS HEALTH SYSTEM
Practice address
865 Lincoln Rd
Suite 400
Bettendorf, IA 52722-4190
Phone
(563) 355-7548
Fax
(563) 355-7540
NPI assigned
Sep 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Authorized official

Name
Mr. Mark G Rogers
Title
Vice President of Finance
Phone
(563) 421-6513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

865 Lincoln Rd
Suite 400
Bettendorf, IA 52722-4190

Mailing address

865 Lincoln Rd
Suite L10
Bettendorf, IA 52722-4190
Phone (563) 355-9191

Other identifiers 1

IdentifierTypeStateIssuer
572710009OtherDMERC

Other names 1

  • Genesis Health Group Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1023112448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD",
            "address_2": "SUITE L10",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224190",
            "telephone_number": "563-355-9191",
            "fax_number": "563-355-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD",
            "address_2": "SUITE 400",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224190",
            "telephone_number": "563-355-7548",
            "fax_number": "563-355-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "563-421-6513",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "572710009",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Health Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.