Jill L. Lightfoot, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

39362 Issued in IA

Practice address

4700 E 56TH St Ste 100
Davenport, IA 52807-2904

Phone

(563) 421-9100

Fax

(563) 421-9129

NPI assigned

Jun 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jill L. Peterson Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Iowa, RJ & L Carver College of Medicine, 2007

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)

Merit-based Incentive Payment System (MIPS)

Final score

34.85 of 100Reported as group

Quality

21.4

Improvement activities

0

Cost

76.92

Procedures performed for Medicare patients

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

  • Surgery Physician
  • Davenport, IA
  • NPI 1528616901

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Accredited Dermatology Associates, P.C.

  • Dermatology Physician
  • Davenport, IA
  • NPI 1326176983
  Medicare reassignment NPD
• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  NPD
• Genesis Health System

  • Family Medicine Physician
  • Moline, IL
  • NPI 1164538435
  NPD (past)

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1609071364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 E 56TH ST STE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072904",
            "telephone_number": "563-421-9100",
            "fax_number": "563-421-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 E 56TH ST STE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072904",
            "telephone_number": "563-421-9100",
            "fax_number": "563-421-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTFOOT",
        "first_name": "JILL",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "R8125",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R8125",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "39362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "PETERSON",
            "middle_name": "L.",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Lietz
• Life Labyrinth Psychotherapy
• Lifetime Eyehealth Associates PC
• Lifetime Family Chiropractic
• Andrew J Lightfoot, MD
• Damien Perry Lihs
• Wendy M Lind, DNP, ARNP
• Jenay Lee Lindsey, DNP
• Michael Joseph Link, DDS
• Addie Marie Lintz, ARNP

• Dermatology Physician in Davenport, IA
• Providers in Davenport, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.
• 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.