NPIMap

Individual provider Active NPI

Karen Marie Fitzsimmons, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Davenport, IA
National Provider Identifier
1821099490
Registry record updated Apr 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
31689 Issued in IA
Practice address
1227 E Rusholme St
Davenport, IA 52803-2459
Phone
(563) 421-6777
Fax
(563) 421-6770
NPI assigned
Aug 4, 2005
Last updated
Apr 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 31689 IA Primary

Addresses

Primary practice location

1227 E Rusholme St
Davenport, IA 52803-2459

Mailing address

1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 421-6777

Other identifiers 1

IdentifierTypeStateIssuer
1149682MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address karen.fitzsimmons@direct.genesishealth.com Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040209000648 IA Practitioner - Pathology 4789578154 Reassigns benefits to 1 organization
I20100517000652 IL Practitioner - Pathology 4789578154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Iowa, RJ & L Carver College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Mercyone Genesis Davenport Patholog
Davenport, IA 52803-2459
Phone (563) 421-6610

855 Illini Dr
Suite 203
Silvis, IL 61282-2904
Phone (563) 421-6772

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31689IAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2016 Accepting new patients
Genesis Health System Current Accepting new patients
Genesis Health System CurrentSince Apr 1, 2016 Accepting new patients

Locations

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

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

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

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

619 5th St
Durant, IA 52747
Phone (563) 785-4487

409 NW 9th Ave
Aledo, IL 61231
Phone (309) 582-2227

202 Picard St
Alpha, IL 61413
Phone (309) 629-4601

306 46th Ave
East Moline, IL 61244
Phone (309) 796-2329

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

855 Illini Dr
Ste 203
Silvis, IL 61282
Phone (309) 281-4812

Interoperability endpoints

  • Direct secure messaging: karen.fitzsimmons@direct.genesishealth.com

Ownership & related parties

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercyone Genesis Silvis Medical CenterSilvis, IL, CCN 140275 Hospital Corporate Director Nov 6, 2020
Mercyone GenesisDavenport, IA, CCN 160033 Hospital Corporate Director Nov 6, 2020
Mercyone Genesis Dewitt Medical CenterDe Witt, IA, CCN 161313 Hospital Corporate Director Nov 6, 2020
Mercyone GenesisDavenport, IA, CCN 16T033 Hospital Corporate Director Nov 6, 2020
Mercyone Genesis Dewitt Medical CenterDe Witt, IA, CCN 16Z313 Hospital Corporate Director Nov 6, 2020
Mercyone GenesisAledo, IL, CCN 141304 Hospital Corporate Director Nov 6, 2020
Mercyone GenesisAledo, IL, CCN 14Z304 Hospital Corporate Director Nov 6, 2020
Mercyone GenesisBettendorf, IA, CCN 167012 Home health agency Corporate Director Nov 6, 2020
Mercyone GenesisBettendorf, IA, CCN 161520 Hospice Corporate Director Nov 6, 2020
Mercyone GenesisAledo, IL, CCN 143453 Rural health clinic Corporate Director Nov 6, 2020
Mercyone Genesis Dewitt Family MedicineDe Witt, IA, CCN 168667 Rural health clinic Corporate Director Nov 6, 2020
Mercyone Genesis Dewitt Family MedicineDe Witt, IA, CCN 168671 Rural health clinic Corporate Director Nov 6, 2020

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617494400000",
    "number": "1821099490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-6777",
            "fax_number": "563-421-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-6777",
            "fax_number": "563-421-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-04",
        "last_updated": "2021-04-04",
        "certification_date": "2021-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "31689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1149682",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "karen.fitzsimmons@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1227 E Rusholme St",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528032459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.