Active NPI
Richard Lee Shaffer, DO
- Family Medicine Physician
- Davenport, IA
National Provider Identifier
1972553170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01385
- Practice address
- 4314 Spring St
Davenport, IA 52807-1111 - Phone
- (563) 210-5536
- NPI assigned
- May 11, 2006
- 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 | 01385 | IA | Primary |
Addresses
Primary practice location
4314 Spring St
Davenport, IA 52807-1111
Mailing address
4314 Spring St
Davenport, IA 52807-1111
Phone (563) 359-5183
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01385 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Health System | Past | Accepting new patients | |
| Genesis Health System | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinic/Center
- Davenport, IA
- NPI 1205860400
-
- Clinic/Center
- Bettendorf, IA
- NPI 1497772008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487289600000",
"number": "1972553170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4314 SPRING ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528071111",
"telephone_number": "563-359-5183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4314 SPRING ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528071111",
"telephone_number": "563-210-5536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "RICHARD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2017-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "01385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.