Active NPI
William P Jerome, MD
- Internal Medicine Physician
- Bettendorf, IA
National Provider Identifier
1215915855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 28945
- Practice address
- 4480 Utica Ridge Rd
Suite 2230
Bettendorf, IA 52722-1644 - Phone
- (563) 742-5150
- Fax
- (563) 742-5165
- NPI assigned
- Jan 4, 2006
- Last updated
- Feb 5, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 28945 | IA | Primary |
Addresses
Primary practice location
4480 Utica Ridge Rd
Suite 2230
Bettendorf, IA 52722-1644
Mailing address
4480 Utica Ridge Rd
Suite 2230
Bettendorf, IA 52722-1644
Phone (563) 742-5150
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215915855 | Medicaid | IA | |
| 110228331 | Other | IA | RR MEDICARE |
| 3151225 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Health System | Past | Accepting new patients |
Organizations & group practices 1
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": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1215915855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4480 UTICA RIDGE RD",
"address_2": "SUITE 2230",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527221644",
"telephone_number": "563-742-5150",
"fax_number": "563-742-5165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4480 UTICA RIDGE RD",
"address_2": "SUITE 2230",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527221644",
"telephone_number": "563-742-5150",
"fax_number": "563-742-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEROME",
"first_name": "WILLIAM",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "28945",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1215915855",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110228331",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3151225",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}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 Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.