NPIMap

Organization Active NPI

Genesis Health System

Doing business as Genesis Medical Center Davenport

  • General Acute Care Hospital
  • Davenport, IA
National Provider Identifier
1972542264
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
GENESIS HEALTH SYSTEM
Doing business as
Genesis Medical Center Davenport
Practice address
1227 E Rusholme St
Davenport, IA 52803-2459
Phone
(563) 421-3402
Fax
(563) 421-3419
NPI assigned
Jun 5, 2006
Last updated
Jul 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Authorized official

Name
Jordan Voigt
Title
President
Phone
(563) 421-6485

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU
Rehabilitation Hospital Unit 273Y00000X NU
Substance Use Disorder Rehabilitation Hospital Unit 276400000X NU
General Acute Care Hospital 282N00000X IA Primary
Ambulance 341600000X IA

Addresses

Primary practice location

1227 E Rusholme St
Davenport, IA 52803-2459

Mailing address

1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 421-3402

Other identifiers 13

IdentifierTypeStateIssuer
0109710MedicaidIA
0308577MedicaidIA
0310037MedicaidIA
0143222MedicaidIA
3310060MedicaidIA
60033OtherIABLUE CROSS ACUTE
009755OtherHEALTH ALLIANCE UB
H80OtherMIDLANDS CHOICE
0253484MedicaidIA
370062800OtherDEPT OF LABOR
0197558MedicaidIA
0600338MedicaidIA
0106344MedicaidIA

Other names 1

  • GENESIS MEDICAL CENTER DAVENPORT Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA3 enrollments

Enrollment records 3

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
O20060825000387 IA Part A Provider - Hospital 7214841436 Practice locations: Leclaire, IA; Durant, IA; Davenport, IA; Bettendorf, IA
O20221201001868 IA Part B Supplier - Intensive Cardiac Rehabilitation 7214841436 Practice locations: Davenport, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972542264. Details of each certification follow.

Hospital certification: CCN 160033

Legal name
GENESIS HEALTH SYSTEM
Doing business as
MERCYONE GENESIS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 28, 2014
Beds
502
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1227 E Rusholme St
Davenport, IA 52803-2459
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 16

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

View all 16

Care Compare: Hospital

Medicare Care Compare
Listed as
Genesis Medical Center-DavenportCCN 160033 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1236 E Rusholme St
Ste 190
Davenport, IA 52803
Phone (563) 421-6937

1970 E 53rd St
Davenport, IA 52807
Phone (563) 359-3949

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lyn Ketelsen Individual Corporate DirectorBoard Member Jan 4, 2024
Jordan Voigt Individual Corporate OfficerPresident Jan 4, 2024
Corporate DirectorBoard Member Jan 4, 2024
Charles D Waterman Individual Corporate OfficerChair Apr 30, 2006
Corporate DirectorBoard Member Apr 30, 2006
Robert P Ritz Individual Corporate DirectorBoard Member Mar 1, 2023
Melissa C Pepper Individual Corporate OfficerSecretary Nov 1, 2019
Corporate DirectorBoard Member Nov 1, 2019
Peter Benson Individual Corporate OfficerVice Chair Sep 26, 2014
Corporate DirectorBoard Member Sep 26, 2014
Robin R Petersen Individual Corporate DirectorBoard Member Jul 29, 2004
Christopher M Crome Individual Corporate OfficerChief Medical Officer Nov 1, 2021
Lashonda Polite Individual Corporate DirectorBoard Member Nov 6, 2020
Edmund P Coyne Individual Corporate DirectorBoard Member Dec 4, 2008
Karen M Fitzsimmons Individual Corporate DirectorBoard Member Nov 6, 2020
Mercy Health Network Inc Organization, Clive, IA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 1, 2023 100%
Mark C. Kilmer Individual Corporate DirectorBoard Member Sep 30, 2003
Dale D Zude Individual Corporate OfficerTreasurer Jan 1, 2025
Corporate DirectorBoard Member Sep 25, 2001
Edwin V Motto Individual Corporate DirectorBoard Member Jul 23, 1996
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Mar 1, 2023 100%
Patricia S Groves Individual Corporate DirectorBoard Member Oct 9, 2015
David Larson Individual Corporate DirectorBoard Member Mar 6, 2014
Pamela Scott Individual W-2 Managing EmployeeRevenue Integrity Administrator Jan 1, 2006

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Fieldstone of DewittDe Witt, IA, CCN 165619 Skilled nursing facility 5% Or Greater Direct Ownership Interest (40%) Feb 21, 2019
The Summit of BettendorfBettendorf, IA, CCN 165793 Skilled nursing facility 5% Or Greater Direct Ownership Interest (40%) Feb 21, 2019

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 215

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 215

Practitioners & affiliated clinicians

Practitioners 166

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 166

Affiliated clinicians 715

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 715

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1972542264",
    "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": "563-421-3402",
            "fax_number": "563-421-3419"
        },
        {
            "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": "563-421-3402",
            "fax_number": "563-421-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "VOIGT",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-421-6485"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0109710",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0308577",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0310037",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143222",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3310060",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ACUTE",
            "identifier": "60033",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE UB",
            "identifier": "009755",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "H80",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0253484",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "370062800",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0197558",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600338",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106344",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GENESIS MEDICAL CENTER DAVENPORT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.