Active NPI
John C Dannenfeldt, MD
- Family Medicine Physician
- Silvis, IL
National Provider Identifier
1881699890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036059049
- Practice address
- 855 Illini Dr
Ste 300
Silvis, IL 61282-2904 - Phone
- (309) 281-2090
- Fax
- (309) 281-2099
- NPI assigned
- Jun 16, 2005
- Last updated
- Apr 13, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036059049 | IL | Primary |
Addresses
Primary practice location
855 Illini Dr
Ste 300
Silvis, IL 61282-2904
Mailing address
865 Lincoln Rd
Ste L10
Bettendorf, IA 52722-4159
Phone (563) 355-9191
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020348 | Other | HEALTH ALLIANCE | |
| 4796890014 | Other | DMERC | |
| 97835 | Other | IA | WELLMARK BC/BS |
| 20127 | Other | IOWA HEALTH SOLUTIONS | |
| IL0120 | Other | JOHN DEERE HEALTH PLAN | |
| 036059049 | Medicaid | IL | |
| 97788 | Other | IA | WELLMARK BC/BS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | john.dannenfeldt@direct.genesishealth.com | Direct |
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
Interoperability endpoints
- john.dannenfeldt@direct.genesishealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1881699890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "865 LINCOLN RD",
"address_2": "STE L10",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527224159",
"telephone_number": "563-355-9191",
"fax_number": "563-355-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 ILLINI DR",
"address_2": "STE 300",
"city": "SILVIS",
"state": "IL",
"postal_code": "612822904",
"telephone_number": "309-281-2090",
"fax_number": "309-281-2099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANNENFELDT",
"first_name": "JOHN",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036059049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "020348",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "4796890014",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BC/BS",
"identifier": "97835",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA HEALTH SOLUTIONS",
"identifier": "20127",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH PLAN",
"identifier": "IL0120",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036059049",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BC/BS",
"identifier": "97788",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "john.dannenfeldt@direct.genesishealth.com",
"affiliation": "N",
"endpointDescription": "Genesis Health System Direct Email. Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "855 Illini Dr",
"address_2": "Ste 300",
"city": "Silvis",
"state": "IL",
"country_code": "US",
"postal_code": "612822904",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Silvis, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.