Individual provider Active NPI

Rebecca Wagschal, ARNP, CNM

  • Midwife
  • Davenport, IA
National Provider Identifier
1164878542
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
B-129554 Issued in IA
Practice address
1510 E Rusholme St
Davenport, IA 52803-2463
Phone
(563) 336-3000
Fax
(563) 324-4160
NPI assigned
May 4, 2016
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G178943 IA
Women's Health Nurse Practitioner 363LW0102X F166745 IA
Midwife 176B00000X B-129554 IA Primary

Addresses

Primary practice location

1510 E Rusholme St
Davenport, IA 52803-2463

Mailing address

500 W River Dr
Davenport, IA 52801-1014
Phone (563) 336-3000

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidIL
PENDINGMedicaidIA

Other names 1

  • Rebecca Kleinow-Wagschal Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608001177 IA Practitioner - Certified Nurse Midwife (CNM) 2062702715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians
Community Health Care IncGroup PAC ID 9830008895, 56 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

1510 E Rusholme St
Edgerton Womens Health Center
Davenport, IA 52803-2463
Phone (563) 336-3000

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
B-129554IAMDMidwife
G178943IAMDPsychiatric/Mental Health Nurse Practitioner
F166745IAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care, Inc CurrentSince May 9, 2016 Accepting new patients
Genesis Health System CurrentSince Apr 15, 2017 Accepting new patients
Genesis Health System CurrentSince Apr 15, 2017 Accepting new patients
Community Health Care, Inc. Current Accepting new patients
Community Health Care Inc CurrentSince May 9, 2016 Accepting new patients
Community Health Care, Inc. Current Accepting new patients

Locations

925 S 4th St
Clinton, IA 52732
Phone (563) 205-3578

1510 E Rusholme St
Davenport, IA 52803
Phone (563) 359-6633

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

500 W River Dr
Davenport, IA 52801
Phone (563) 327-2035

619 5th St
Durant, IA 52747
Phone (563) 785-4487

1106 4th Ave
Moline, IL 61265
Phone (309) 623-4817

Interoperability endpoints

  • Direct secure messaging: rwagschal635663@direct.ochin.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1164878542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W RIVER DR",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011014",
            "telephone_number": "563-336-3000",
            "fax_number": "563-324-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032463",
            "telephone_number": "563-336-3000",
            "fax_number": "563-324-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSCHAL",
        "first_name": "REBECCA",
        "credential": "ARNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G178943",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IA",
            "license": "F166745",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "IA",
            "license": "B-129554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "KLEINOW-WAGSCHAL",
            "credential": "ARNP, CNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.