NPIMap

Organization Active NPI

Genesis Health System

  • Surgery Physician
  • Davenport, IA
National Provider Identifier
1528616901
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GENESIS HEALTH SYSTEM
Practice address
1227 E Rusholme St
Davenport, IA 52803-2459
Phone
(563) 421-3408
Fax
(563) 421-3419
NPI assigned
Aug 29, 2019
Last updated
Jul 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Authorized official

Name
Arun Arora
Title
VP of Finance
Phone
(563) 421-6508

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Hematology & Oncology Physician 207RH0003X
Infectious Disease Physician 207RI0200X
Pulmonary Disease Physician 207RP1001X
Neurological Surgery Physician 207T00000X
Physical Medicine & Rehabilitation Physician 208100000X
Surgery Physician 208600000X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
Health Psychologist 103TH0004X

Addresses

Primary practice location

1227 E Rusholme St
Davenport, IA 52803-2459

Mailing address

PO Box 310083
Des Moines, IA 50331-0083
Phone (563) 421-3408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191031002622 IA Part B Supplier - Clinic/Group Practice 6103829338 Receives reassigned benefits from 397 practitioners
Practice locations: Bettendorf, IA; Davenport, IA; Clinton, IA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1351 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-1900

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

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercyone GenesisAledo, IL, CCN 141304 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2013
Mercyone GenesisAledo, IL, CCN 14Z304 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
Mercyone GenesisAledo, IL, CCN 143453 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2013

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 487

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 487

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1528616901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310083",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503310083",
            "telephone_number": "563-421-3408",
            "fax_number": "563-421-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-3408",
            "fax_number": "563-421-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-29",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "ARUN",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "563-421-6508"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.