NPIMap

Organization Active NPI

Family Health Partners of the Quad Cities, PC

  • Family Medicine Physician
  • Davenport, IA
National Provider Identifier
1730288556
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26742 Issued in IA
Legal business name
FAMILY HEALTH PARTNERS OF THE QUAD CITIES, PC
Practice address
3385 Dexter CT
Suite 103
Davenport, IA 52807-3471
Phone
(563) 441-5860
Fax
(563) 441-5865
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffrey S Walczyk, MDNPI 1508843384
Title
Owner/President
Phone
(563) 441-5860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 26742 IA Primary

Addresses

Primary practice location

3385 Dexter CT
Suite 103
Davenport, IA 52807-3471

Mailing address

3385 Dexter CT
Suite 103
Davenport, IA 52807-3471
Phone (563) 441-5860

Other identifiers 1

IdentifierTypeStateIssuer
0256800MedicaidIA

National Provider Directory

National Provider Directory

Locations

3385 Dexter Ct
Ste 10
Davenport, IA 52807
Phone (563) 441-5860

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730288556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT",
            "address_2": "SUITE 103",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073471",
            "telephone_number": "563-441-5860",
            "fax_number": "563-441-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT",
            "address_2": "SUITE 103",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073471",
            "telephone_number": "563-441-5860",
            "fax_number": "563-441-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH PARTNERS OF THE QUAD CITIES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALCZYK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "563-441-5860",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "26742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0256800",
            "state": "IA"
        }
    ],
    "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 Aug 22, 2020; 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.