Cecil Wayne Gallops, D.O.
Individual provider Active NPI Emergency Medicine Physician · Silvis, IL
NPI 1366497133 · NPPES record last updated Jun 1, 2021
Key facts
- NPI
- 1366497133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 036-082049 (IL)
- Practice address
- 801 Illini Dr
Silvis, IL 61282-1804 - Phone
- (309) 792-7043
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040609000068 | IL | Practitioner - Emergency Medicine | 1052224540 | Reassigns benefits to 1 organization |
| I20140403002066 | IA | Practitioner - Emergency Medicine | 1052224540 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-082049 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Public Hospital | Current |
Accepting new patients | |
| Genesis Health System | Current |
Accepting new patients | |
| Genesis Health System | Current |
Accepting new patients | |
| Jackson County Public Hospital | Current |
Accepting new patients | |
| Jackson County Public Hospital | Past | Accepting new patients | |
| Jackson County Public Hospital | Past | Accepting new patients | |
| Genesis Health System | Past | Accepting new patients |
Locations
1351 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-1900
1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287
1118 11th St
De Witt, IA 52742
Phone (563) 242-7522
601 Hospital Dr
Maquoketa, IA 52060
Phone (563) 652-2474
801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036-082049 | IL | Yes |
Addresses
Primary practice location
801 Illini Dr
Silvis, IL 61282-1804
Mailing address
801 Illini Dr
Silvis, IL 61282-1804
Phone (309) 281-7065
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E70596 | Other | IL | BLUE CROSS BLUE SHIELD |
| 930010658 | Other | RAILROAD MEDICARE | |
| 054320 | Other | HEALTH ALLIANCE | |
| 41053 | Medicaid | IL | |
| E70596 | Other | TRICARE | |
| 96928 | Other | IA | BLUE CROSS BLUE SHIELD |
| 239407 | Other | MIDLANDS CHOICE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | c.wayne.gallops@direct.genesishealth.com | Direct |
Other providers in Silvis, IL
- Rachael Kathleen Evans-Krack
- Naira Taiba Fatima
- Katherine Finch
- Kristine Renee Fleming
- Fresenius Medical Care Quad Cities, LLC
- Karen Marie Garner
- Paul Garner
- Laurie Michelle Geest
- Genesis Health System
- Genesis Health System
All providers in Silvis, IL · Emergency Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.