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Organization Active NPI

Genesis Health System

Doing business as Genesis Psychiatric Hospitalists

  • Psychiatric Hospital Unit
  • Davenport, IA
National Provider Identifier
1710276183
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
GENESIS HEALTH SYSTEM
Doing business as
Genesis Psychiatric Hospitalists
Practice address
1401 W Central Park Ave
Davenport, IA 52804-1707
Phone
(563) 421-1288
Fax
(563) 421-1280
NPI assigned
Apr 6, 2011
Last updated
Apr 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

1401 W Central Park Ave
Davenport, IA 52804-1707

Mailing address

865 Lincoln Rd Ste L10
Bettendorf, IA 52722-4159
Phone (563) 355-9200

Other names 1

  • Genesis Psychiatric Hospitalists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000044 IA Part B Supplier - Clinic/Group Practice 7214841436 Receives reassigned benefits from 306 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bettendorf, IA; Davenport, IA; Eldridge, IA; Durant, IA; De Witt, IA

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1710276183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD STE L10",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224159",
            "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": "1401 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041707",
            "telephone_number": "563-421-1288",
            "fax_number": "563-421-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "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/CFO",
        "authorized_official_telephone_number": "563-421-6513"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Psychiatric Hospitalists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.