NPIMap

Organization Active NPI

Genesis Health System

Doing business as Genesis Health Group

  • Pediatrics Physician
  • Silvis, IL
National Provider Identifier
1063520310
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GENESIS HEALTH SYSTEM
Doing business as
Genesis Health Group
Practice address
855 Illini Dr
Suite 304
Silvis, IL 61282-2907
Phone
(309) 792-6350
Fax
(309) 792-3322
NPI assigned
Aug 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

855 Illini Dr
Suite 304
Silvis, IL 61282-2907

Mailing address

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

Other names 1

  • Genesis Health Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dav Med37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

855 Illini Dr
Ste 304
Silvis, IL 61282
Phone (309) 281-2120

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063520310",
    "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": "855 ILLINI DR",
            "address_2": "SUITE 304",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612822907",
            "telephone_number": "309-792-6350",
            "fax_number": "309-792-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEINSCHMIDT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "563-421-6513",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Health Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Silvis, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.