Individual provider Active NPI

Lindsay Jo Davenport, PA-C

  • Physician Assistant
  • Davenport, IA
National Provider Identifier
1457800377
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08667 Issued in NC
Practice address
1228 E Rusholme St
Davenport, IA 52803-2453
Phone
(563) 421-7540
Fax
(563) 421-7549
NPI assigned
Oct 4, 2016
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 021905 NY
Physician Assistant 363A00000X MA058491 PA
Physician Assistant 363A00000X 0010-08667 NC Primary

Addresses

Primary practice location

1228 E Rusholme St
Davenport, IA 52803-2453

Mailing address

62 Crestwood Ter
Davenport, IA 52803-3719
Phone (412) 605-8843

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lschricker714357@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808000179 IA Practitioner - Physician Assistant 6901186493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

4700 E 56TH St
Davenport, IA 52807-2904

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
34.85 of 100Reported as group
Quality
21.4
Improvement activities
0
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-08667NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Aug 7, 2023 Accepting new patients

Locations

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

Interoperability endpoints

  • Direct secure messaging: lschricker714357@direct.novanthealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1457800377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CRESTWOOD TER",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528033719",
            "telephone_number": "412-605-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032453",
            "telephone_number": "563-421-7540",
            "fax_number": "563-421-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "LINDSAY",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021905",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058491",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lschricker714357@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2825 Lyndhurst Ave Ste 101",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271034146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.