Individual provider Active NPI

Blair W Foreman, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Davenport, IA
National Provider Identifier
1750360616
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
29445 Issued in IA
Practice address
1236 E Rusholme St Ste 300
Davenport, IA 52803-2473
Phone
(633) 242-9925
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 29445 IA Primary

Addresses

Primary practice location

1236 E Rusholme St Ste 300
Davenport, IA 52803-2473

Mailing address

630 Riverview Ter
Bettendorf, IA 52722-4041
Phone (563) 508-4597

Other identifiers 2

IdentifierTypeStateIssuer
060055859OtherMEDICARE RAILROAD
3114827MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040428001001 IA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 9032106307 Reassigns benefits to 2 organizations
I20061205000187 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 9032106307 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Jul 1, 2006 Accepting new patients
Genesis Health System CurrentSince Jul 1, 2006 Accepting new patients
Trinity Medical Center Current Accepting new patients
Genesis Health System CurrentSince Jul 1, 2006 Accepting new patients
Cardiovascular Medicine PLLC CurrentSince Aug 8, 1999 Accepting new patients
Genesis Health System Current Accepting new patients

Locations

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

1236 E Rusholme St
Ste 300
Davenport, IA 52803
Phone (319) 324-2992

1401 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-1900

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

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

210 W Elk St
Geneseo, IL 61254
Phone (309) 743-6700

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1750360616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 RIVERVIEW TER",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224041",
            "telephone_number": "563-508-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 E RUSHOLME ST STE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032473",
            "telephone_number": "633-242-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "BLAIR",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IA",
            "license": "29445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "060055859",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3114827",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.