Individual provider Active NPI

Ellen Hosch, RD, CDE

  • Registered Dietitian
  • Davenport, IA
National Provider Identifier
1669921607
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00626 Issued in IA
Practice address
1345 W Central Park Ave
Davenport, IA 52804-1844
Phone
(563) 421-4400
Fax
(563) 421-4445
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 00626 IA Primary

Addresses

Primary practice location

1345 W Central Park Ave
Davenport, IA 52804-1844

Mailing address

PO Box 4028
Rock Island, IL 61204-4028
Phone (563) 355-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180924000107 IA Practitioner - Registered Dietitian Or Nutrition Professional 1658622170 Reassigns benefits to 1 organization
I20221230002433 IL Practitioner - Registered Dietitian Or Nutrition Professional 1658622170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

2535 Maplecrest Rd
Suite 13
Bettendorf, IA 52722-2794
Phone (563) 421-3290

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00626IAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Aug 11, 2018 Accepting new patients
Genesis Health System CurrentSince Aug 11, 2018 Accepting new patients
Genesis Health System Past Accepting new patients

Locations

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

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

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

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

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

202 Picard St
Alpha, IL 61413
Phone (309) 629-4601

306 46th Ave
East Moline, IL 61244
Phone (309) 796-2329

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1669921607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4028",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612044028",
            "telephone_number": "563-355-9200",
            "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": "563-421-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSCH",
        "first_name": "ELLEN",
        "credential": "RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "00626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.