Mark Stephen Stumphy, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019030322 Issued in IL

Practice address

125 Scott St
Davenport, IA 52801-1130

Phone

(563) 336-3000

Fax

(563) 336-3229

NPI assigned

Aug 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dentist

Education

Univ of Illinois at Chicago College of Dentistry, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Davenport, IA
  • NPI 1932193224
  Medicare reassignment
• Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rock Island, IL
  • NPI 1598759292
  Medicare reassignment
• Community Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Muscatine, IA
  • NPI 1275175002
  NPD
• Community Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • East Moline, IL
  • NPI 1669360459
  NPD
• Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Moline, IL
  • NPI 1710971486
  NPD

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1245607209",
    "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": "563-336-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SCOTT ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011130",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMPHY",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josie Strodtman, M.A., CRC, TLMHC
• Steven M Strom, DO
• Shannon Leigh Strombeck, B.S, CADC
• Melissa Stromberger
• Kimberly Ann Stumpf, L.M.T
• Jean Marie Styvaert, APN
• Julie Kay Suhl, P.T.
• Kassidy Lyn Suiter, B.A CADC
• Melinda Sullins, MHS, RD, LD
• Michael Thomas Sunderbruch, M.D.

• General Practice Dentistry in Davenport, IA
• Providers in Davenport, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.