Active NPI
Stephen M Thompson, DO
- Family Medicine Physician
- Davenport, IA
National Provider Identifier
1457357253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02662
- Practice address
- 210 W 53Rd St
Davenport, IA 52806-2251 - Phone
- (563) 386-8250
- Fax
- (563) 386-3211
- NPI assigned
- Jun 27, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02662 | IA | Primary |
Addresses
Primary practice location
210 W 53Rd St
Davenport, IA 52806-2251
Mailing address
865 Lincoln Rd
Ste L10
Bettendorf, IA 52722-4159
Phone (563) 355-9191
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IA0159 | Other | JOHN DEERE HEALTH PLAN | |
| 034795 | Other | HEALTH ALLIANCE | |
| 20116 | Other | IOWA HEALTH SOLUTIONS | |
| 4796890009 | Other | DMERC | |
| 40209 | Other | WELLMARK HEALTH PLANS | |
| 5074773 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | stephen.thompson@direct.genesishealth.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1351 W Central Park
Suite 340
Davenport, IA 52804-1889
1351 W Central Park Ave
Suite 340
Davenport, IA 52804-1889
2100 S 21St St B
Clinton, IA 52732-6814
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Health System | Family Medicine | 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 and National Provider Directory roles.
-
- Family Medicine Physician
- Bettendorf, IA
- NPI 1225018211
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632441600000",
"number": "1457357253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "865 LINCOLN RD",
"address_2": "STE L10",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527224159",
"telephone_number": "563-355-9191",
"fax_number": "563-355-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 W 53RD ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528062251",
"telephone_number": "563-386-8250",
"fax_number": "563-386-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "STEPHEN",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2021-09-24",
"certification_date": "2021-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "02662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH PLAN",
"identifier": "IA0159",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "034795",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA HEALTH SOLUTIONS",
"identifier": "20116",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "4796890009",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK HEALTH PLANS",
"identifier": "40209",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5074773",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "stephen.thompson@direct.genesishealth.com",
"affiliation": "N",
"endpointDescription": "Genesis Health System Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "3200 W Kimberly Rd",
"city": "Davenport",
"state": "IA",
"country_code": "US",
"postal_code": "528063059",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.