Individual provider Active NPI

Kurt A Andersen, MD

  • Family Medicine Physician
  • Davenport, IA
National Provider Identifier
1477558799
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32593 Issued in IA
Practice address
1345 W Central Park Ave
Davenport, IA 52804-1844
Phone
(563) 421-4400
Fax
(563) 386-7349
NPI assigned
Jun 14, 2005
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 32593 IA Primary

Addresses

Primary practice location

1345 W Central Park Ave
Davenport, IA 52804-1844

Mailing address

865 Lincoln Rd
Ste L10
Bettendorf, IA 52722-4159
Phone (563) 355-9191

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kurt.andersen@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32593IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Family Medicine CurrentSince Jul 1, 2006 Accepting new patients
Genesis Health System CurrentSince Jul 1, 2006 Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients
Mercy Health Services- Iowa Corp PastSince Jan 1, 2024 Accepting new patients
Genesis Medical Education Foundation Inc Family Medicine Past Accepting new patients
Covenant Medical Center, Inc. PastSince Jan 1, 2025 Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients

Locations

865 Lincoln Rd
Ste L10
Bettendorf, IA 52722
Phone (563) 355-9191

1345 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-4400

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

1401 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-1900

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

3618 N Division St
Davenport, IA 52806
Phone (319) 391-4827

619 5th St
Durant, IA 52747
Phone (563) 785-4487

2560 24th St
Ste 202
Rock Island, IL 61201
Phone (309) 786-3395

Interoperability endpoints

  • Direct secure messaging: kurt.andersen@direct.genesishealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1477558799",
    "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": "1345 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041844",
            "telephone_number": "563-421-4400",
            "fax_number": "563-386-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "KURT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "32593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kurt.andersen@direct.genesishealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.