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GENESIS HEALTH SYSTEM NPI 1922012764


NPI Information

NPI: 1922012764
Provider Name: GENESIS HEALTH SYSTEM

Doing Business As: GENESIS FAMILY MEDICAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 16D0387972

Address:
1345 W CENTRAL PARK AVE
DAVENPORT, IA
ZIP 52804
Phone: (563) 421-4400
Get Directions

GENESIS HEALTH SYSTEM is a family medicine in Davenport, IA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GENESIS HEALTH SYSTEM NPI is 1922012764. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Genesis Family Medical Center.

The provider's business location address is:

1345 W CENTRAL PARK AVE
DAVENPORT, IA
ZIP 52804-844
Phone: (563) 421-4400
Fax: (563) 421-4449

The provider's authorized official is Terri Walz .
The authorized official title is Program Assistant and has the following contact phone number (563) 421-4400.

The CLIA number assigned to this NPI record is 16D0387972 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10495747MEDICAIDIOWA
20495952MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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