Genesis Health System

Organization Active NPI Infectious Disease Physician · Davenport, IA

NPI 1922050814 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1922050814
Entity type
Organization (NPI type 2)
Primary specialty
Infectious Disease Physician 207RI0200X
Legal business name
GENESIS HEALTH SYSTEM
Practice address
1227 E Rusholme St
Davenport, IA 52803-2459
Phone
(563) 421-4244
Fax
(563) 421-4285
NPI assigned
May 17, 2006
Organization subpart
No

Authorized official

Name
Mr. Mark J. Kleinschmidt
Title
Vice President of Finance
Phone
(563) 421-6513

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Member organizations 19

Organizations listed as members of this organization in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031113000044 IA Part B Supplier - Clinic/Group Practice 7214841436 Receives reassigned benefits from 306 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bettendorf, IA; Davenport, IA; Eldridge, IA; Durant, IA; De Witt, IA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RI0200X Yes

Addresses

Primary practice location

1227 E Rusholme St
Davenport, IA 52803-2459

Mailing address

1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 421-4244

Other names

  • Genesis Medical Center - Infectious Disease Doing business as

Other providers in Davenport, IA

All providers in Davenport, IA · Infectious Disease Physician in Iowa

Sources for this page

Verify at the official NPI Registry.