Individual provider Active NPI

Phyllis L Whaley, FNP-C

  • Nurse Practitioner
  • Bettendorf, IA
National Provider Identifier
1780407601
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A181009 Issued in IA
Practice address
2535 Maplecrest Rd
Bettendorf, IA 52722-7709
Phone
(563) 421-4620
NPI assigned
Nov 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A181009 IA Primary

Addresses

Primary practice location

2535 Maplecrest Rd
Bettendorf, IA 52722-7709

Mailing address

1351 W Central Park Ave Ste 4100
Davenport, IA 52804-1847
Phone (563) 355-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250326000907 IA Practitioner - Nurse Practitioner 0840713301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

2535 Maplecrest Rd
Suite 10
Bettendorf, IA 52722-2799
Phone (563) 421-4620

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A181009IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Mar 10, 2025 Accepting new patients
Genesis Health System CurrentSince Mar 10, 2025 Accepting new patients
Genesis Health System PastSince Nov 10, 2024 Accepting new patients

Locations

2535 Maplecrest Rd
Ste 10
Bettendorf, IA 52722
Phone (319) 344-3500

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1780407601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 W CENTRAL PARK AVE STE 4100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041847",
            "telephone_number": "563-355-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 MAPLECREST RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227709",
            "telephone_number": "563-421-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "PHYLLIS",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A181009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.