Individual provider Active NPI

Geeta Mahadevia, M.D.

  • Occupational Medicine Physician
  • Davenport, IA
National Provider Identifier
1720040835
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
25281 Issued in IA
Practice address
3319 Spring St
Suite 103
Davenport, IA 52807-2125
Phone
(563) 324-0696
Fax
(563) 324-0697
NPI assigned
Apr 4, 2006
Last updated
Nov 7, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 25281 IA Primary
Occupational Medicine Physician 2083X0100X IL

Addresses

Primary practice location

3319 Spring St
Suite 103
Davenport, IA 52807-2125

Mailing address

3319 Spring St
Suite 103
Davenport, IA 52807-2125
Phone (563) 324-0696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-067540ILMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Past Accepting new patients
Genesis Health System Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1720040835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 SPRING ST",
            "address_2": "SUITE 103",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072125",
            "telephone_number": "563-324-0696",
            "fax_number": "563-324-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 SPRING ST",
            "address_2": "SUITE 103",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072125",
            "telephone_number": "563-324-0696",
            "fax_number": "563-324-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHADEVIA",
        "first_name": "GEETA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IA",
            "license": "25281",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 7, 2007; 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.