NPIMap

Organization Active NPI

Genesis Health System

Doing business as Genesis Health Group Bettendorf Pediatric Health Home

  • Pediatrics Physician
  • Bettendorf, IA
National Provider Identifier
1699102863
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GENESIS HEALTH SYSTEM
Doing business as
Genesis Health Group Bettendorf Pediatric Health Home
Practice address
865 Lincoln Rd
Suite 200
Bettendorf, IA 52722-4190
Phone
(563) 344-8600
Fax
(563) 344-2967
NPI assigned
Oct 3, 2013
Last updated
Oct 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Authorized official

Name
Mr. Mark G. Rogers
Title
VP of Finance
Phone
(563) 421-6513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

865 Lincoln Rd
Suite 200
Bettendorf, IA 52722-4190

Mailing address

865 Lincoln Rd
Suite L10
Bettendorf, IA 52722-4190
Phone (563) 355-9200

Other names 1

  • Genesis Health Group Bettendorf Pediatric Health Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Genesis Health System37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1699102863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD",
            "address_2": "SUITE L10",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224190",
            "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": "865 LINCOLN RD",
            "address_2": "SUITE 200",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224190",
            "telephone_number": "563-344-8600",
            "fax_number": "563-344-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "563-421-6513",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Health Group Bettendorf Pediatric Health Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.