NPIMap

Organization Active NPI

Trinity Medical Center

  • Physician Assistant
  • Davenport, IA
National Provider Identifier
1184644783
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
TRINITY MEDICAL CENTER
Doing business as
Trinity MedXpress
Practice address
2351 W Locust St
Davenport, IA 52804-3329
Phone
(563) 324-0133
Fax
(563) 324-1409
NPI assigned
Jul 20, 2006
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
Jennifer Everson, CPC
Title
Business Office Lead/Compliance Coo
Phone
(563) 742-5919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

2351 W Locust St
Davenport, IA 52804-3329

Mailing address

PMB 399
2884 Devils Glen Rd
Bettendorf, IA 52722
Phone (563) 742-5919

Other names 1

  • Trinity MedXpress Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000414 IA Part B Supplier - Clinic/Group Practice 2264337518 Receives reassigned benefits from 159 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bettendorf, IA; Pleasant Valley, IA; Muscatine, IA; Davenport, IA; Coralville, IA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 10

Organizations listed as members of this organization in the National Provider Directory.

Locations

2884 Devils Glen Rd
Bettendorf, IA 52722

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184644783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 399",
            "address_2": "2884 DEVILS GLEN RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "563-742-5919",
            "fax_number": "563-742-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 W LOCUST ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528043329",
            "telephone_number": "563-324-0133",
            "fax_number": "563-324-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BUSINESS OFFICE LEAD/COMPLIANCE COO",
        "authorized_official_telephone_number": "563-742-5919",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity MedXpress",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, IA

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.