Robert J Knudson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33094 Issued in IA

Practice address

4321 53Rd Ave
Bettendorf, IA 52722-1269

Phone

(563) 421-5315

NPI assigned

Oct 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Genesis Health System

  • Clinic/Center
  • Bettendorf, IA
  • NPI 1497772008
  Medicare reassignment NPD (past)
• Genesis Health System

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1477654945
  NPD
• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD
• Genesis Health System

  • Clinic/Center
  • Davenport, IA
  • NPI 1205860400
  NPD (past)

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1528056207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221269",
            "telephone_number": "563-421-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221269",
            "telephone_number": "563-421-5315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4017 Devils Glen Rd",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527227221",
            "country_code": "US",
            "telephone_number": "563-332-6387",
            "fax_number": "563-332-9197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK HEALTH PLAN",
            "identifier": "28675",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH PLAN",
            "identifier": "IA01N6",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.knudson@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4321 53rd Ave",
            "city": "Bettendorf",
            "state": "IA",
            "country_code": "US",
            "postal_code": "527221269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John J Klosak, M.D.
• Chad R Kluver, OD
• Robert J Knott, RPH
• Andrew Jacob Knudsen, PA-C
• Eric Edward Knudson, ATC-LAT
• Sherri Louise Koob, MSW
• Aaron Koopman, CRNA
• Kristi Cappaert Lisw, LCSW
• Deepna Kukreja, MD
• Abigail Kulp, PA-C

• Family Medicine Physician in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.