Individual provider Active NPI

Stephen M Thompson, DO

  • Family Medicine Physician
  • Davenport, IA
National Provider Identifier
1457357253
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02662 Issued in IA
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

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
IA0159OtherJOHN DEERE HEALTH PLAN
034795OtherHEALTH ALLIANCE
20116OtherIOWA HEALTH SOLUTIONS
4796890009OtherDMERC
40209OtherWELLMARK HEALTH PLANS
5074773MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
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

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.