1. Home
  2. Directory
  3. Iowa
  4. Davenport
  5. Family Medicine
  6. NPI Profile

GENESIS FAMILY MEDICAL CENTER
NPI 1922012764
Family Medicine in Davenport, IA

Active since July 28, 2006
1345 W CENTRAL PARK AVE, DAVENPORT, IA 52804(563) 421-4400(563) 421-4449 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Genesis Family Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESIS FAMILY MEDICAL CENTER (NPI 1922012764) is a healthcare organization registered as a family medicine in Davenport, Iowa and active in the NPI registry since July 2006. The organization lists Terri Walz, Program Assistant, as its authorized official.

NPPES Registry Identity

NPI1922012764
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGENESIS HEALTH SYSTEM
Location Address1345 W CENTRAL PARK AVEDavenport, IA 52804-1844
Mailing Address1345 W Central Park AveDavenport, IA 52804-1844 · (563) 421-4400 · Fax (563) 421-4449
Phone(563) 421-4400
Fax(563) 421-4449
Organization SubpartNo
Authorized OfficialTerri WalzProgram Assistant · (563) 421-4400
Enumeration DateJuly 28, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1922012764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
1345 W CENTRAL PARK AVE, Davenport, IA 52804
Open in Google Maps ↗

Other Names 1

Doing Business AsGenesis Family Medical Center

Other Identifiers 2

Medicaid0495747IA
Medicaid0495952IA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Genesis Family Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

299

Medicare enrollment records show 299 clinicians reassign Medicare billing to Genesis Family Medical Center, which bills Medicare for the services they deliver. Of these, 28 practice at this address and 204 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 24

Family Practice77
Nurse Practitioner76
Obstetrics/Gynecology28
Pediatric Medicine23
Cardiovascular Disease (Cardiology)14
Pathology13
Internal Medicine10
Certified Nurse Midwife (CNM)6
16 other specialties52

Nearest to this location (20)

See all 299
Jesicah Ambrisco, DO
Hospitalist
NPI 1023502622
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Gena Benoit, MD
Family Practice
NPI 1730184003
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Mitchell Binkley, MD
Family Practice
NPI 1790215994
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4455
✔ PECOS✔ Accepts MedicareSame address
Ross Burandt
Family Practice
NPI 1093416935
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Kyle Carver, MD
Family Practice
NPI 1457974347
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Troy Dolmetsch, DO
Family Practice
NPI 1194464107
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Manisha Fenzl, MD
Family Practice
NPI 1497285373
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 940-2648
✔ PECOS✔ Accepts MedicareSame address
Andrea Fjelstul-Bonert, MD
Family Practice
NPI 1801699533
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Taryn Hancock, LISW
Clinical Social Worker
NPI 1992846448
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4406
✔ PECOS✔ Accepts MedicareSame address
Sheena Harker, D,O.
Family Practice
NPI 1447544580
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Ellen Hosch, RD, CDE
Registered Dietitian or Nutrition Professional
NPI 1669921607
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ Accepts MedicareSame address
Nicholas Howard, MD
Family Practice
NPI 1225830755
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Bradley Johnson, D.O
Family Practice
NPI 1134116684
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Jong Lee, DO
Emergency Medicine
NPI 1336599869
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4409
✔ PECOS✔ Accepts MedicareSame address
Robert Mixsell, MD
Family Practice
NPI 1598717449
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Madison Purvis, MD
Family Practice
NPI 1396530531
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Stacie Salowitz, M.D.
Family Practice
NPI 1639462443
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Mckenna Sexton, DO
General Practice
NPI 1144959073
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Wendell Shepherd, DO
Family Practice
NPI 1215721428
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
Caroline Sidlinger, DNP
Nurse Practitioner
NPI 1033000344
1345 W CENTRAL PARK AVE
Davenport, IA 52804
(563) 421-4400
✔ PECOS✔ Accepts MedicareSame address
See all 299 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesis Health System's NPI number?

The NPI number for Genesis Health System is 1922012764. It was assigned to this organization in the NPPES registry on July 28, 2006. The provider is doing business as Genesis Family Medical Center.

Where is Genesis Health System located?

Genesis Health System is located at 1345 W Central Park Ave, Davenport, IA 52804. The listed phone number is (563) 421-4400.

What is Genesis Health System's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Genesis Health System enrolled in Medicare?

Yes. Genesis Health System is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Genesis Health System?

According to the CMS Revalidation Reassignment List (October 2026 release), 299 clinicians in 24 Medicare specialties reassign their Medicare billing to Genesis Health System. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (77), Nurse Practitioner (76) and Obstetrics/Gynecology (28). Of these, 28 practice at this address and 204 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Genesis Health System was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.