DAVENPORT EYE GROUP PC (NPI# 1508838954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508838954 |
| Entity Type | Organization |
| Organization Name | DAVENPORT EYE GROUP PC |
| Practice Address |
1230 E Rusholme St Ste 203 Davenport IA 52803-2400 |
| Practice Telephone | 5633220923 |
| Practice Fax Number | 5633227403 |
| Mailing Telephone | 5633220923 |
| Mailing Fax Number | 5633227403 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2009-09-23 |
| Authorized Official Name | SIV BRIT SAETRE (PRESIDENT) |
| Authorized Official Telephone | 5633220923 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE RR | CE7597 | 01 | |
| IA | 0286468 | 05 |
| Street Address |
1230 E RUSHOLME ST STE 203 |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52803-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912902339 | Nancy J Agnew | Nurse Practitioner | 1230 E Rusholme St, Ste 301, Davenport, IA 52803-2400 | 2005-06-14 |
| 1023463890 | Caitlin J Wilson | Physician Assistant | 1230 E Rusholme St, Suite 150, Davenport, IA 52803-2452 | 2016-04-29 |
| 1770971038 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1230 E Rusholme St, Suite 303, Davenport, IA 52803-2452 | 2015-01-08 |
| 1912281940 | Child Protection Response Center | Pediatrics | 1230 E Rusholme St, Mob2, Lower Level, Suite 1, Davenport, IA 52803-2452 | 2011-10-10 |
| 1154643260 | France B Many | Nurse Practitioner | 1230 E Rusholme St, Suite 303, Davenport, IA 52803-2467 | 2010-02-17 |
| 1194957449 | Jody J Kealey | Dietitian, Registered | 1230 E Rusholme St, Suite 305, Davenport, IA 52803-2452 | 2009-08-20 |
| 1952567794 | Quad Cities Retina Consultants | Ophthalmology | 1230 E Rusholme St, Suite 107, Davenport, IA 52803-2400 | 2008-07-31 |
| 1518124841 | Amanda L Bailey | Optometrist | 1230 E Rusholme St, Ste 203, Davenport, IA 52803-2400 | 2008-05-22 |
| 1861508004 | Genesis Health System | Obstetrics & Gynecology | 1230 E Rusholme St, Davenport, IA 52803-2400 | 2006-08-21 |
| 1154357416 | Internal Medicine Associates Prof Corp | Internal Medicine | 1230 E Rusholme St, Suite 303, Davenport, IA 52803-2467 | 2006-06-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679189971 | Amber Rae Rupiper | Physician Assistant | 518 Locus Street, Davenport, IA 52803 | 2020-09-22 |
| 1558869321 | Devan Louis Depauw | Physician Assistant | 1227 East Rusholme St., Davenport, IA 52803 | 2018-01-26 |
| 1215383070 | Brittney N Hughes | Nurse Practitioner | 1228 E Rusholme Street, Suite 3020, Davenport, IA 52803 | 2016-05-11 |
| 1992138747 | Sarah Beth Schlickman | Nurse Practitioner | 1228 E Rusholme St Ste 3020, Davenport, IA 52803 | 2013-08-15 |
| 1154763845 | Leslie A Poston | Nurse Practitioner | 1228 E. Rushome Street, Mob I, Suite 2100, Davenport, IA 52803 | 2013-07-23 |
| 1083878896 | Jolene Marie Dague | Dentist | 1905 N. Main St, Davenport, IA 52803 | 2008-07-11 |
| 1952436370 | Joann C Milani | Psychologist | 1503 Brady Street, Davenport, IL 52803 | 2007-02-23 |
| 1942343579 | Lisa Clare Ploehn | Pharmacist | 129 West Locust Street, Davenport, IA 52803 | 2007-02-14 |
| 1366597957 | Cathleen Ann Clark | Social Worker | 1706 N Brady, Suite 204, Davenport, IA 52803 | 2007-01-24 |
| 1184781940 | William Burke Ltd | Durable Medical Equipment & Medical Supplies | 129 West Locust, Davenport, IA 52803 | 2007-01-02 |
| Find all providers in zip 52803 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124378229 | Andrew J. Hanzlik, M.d., P.a. | Ophthalmology | 2215 North Blvd W, Davenport, FL 33837-8990 | 2012-09-15 |
| 1588736474 | Andrew J Hanzlik | Ophthalmology | 2215 North Blvd West, Davenport, FL 33837 | 2006-11-15 |
| 1417903303 | Lawrence Hugh Hunter | Ophthalmology | 1230 East Rusholme Street, Suite 109, Davenport, IA 58803 | 2006-05-25 |
| 1295107548 | Oculofacial Aesthetics, Plc | Ophthalmology | 5335 Eastern Ave, Suite C, Davenport, IA 52807-2788 | 2015-10-27 |
| 1275763369 | Daniel J Repp | Ophthalmology | 5335 Eastern Ave, Suite C, Davenport, IA 52807-2788 | 2009-07-23 |
| 1952567794 | Quad Cities Retina Consultants | Ophthalmology | 1230 E Rusholme St, Suite 107, Davenport, IA 52803-2400 | 2008-07-31 |
| 1679541973 | Leonardo Miguel Antaris | Ophthalmology | 1230 E Rusholme St, Suite 107, Davenport, IA 52803-2400 | 2006-03-10 |
| 1174595516 | Ashok R Penmatcha | Ophthalmology | 1230 E Rusholme St, Ste 203, Davenport, IA 52803-2400 | 2006-02-01 |
| 1013989441 | Siv Brit Saetre | Ophthalmology | 1230 E Rusholme St, Ste 203, Davenport, IA 52803-2400 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245658673 | Jordan Gross | Ophthalmology | 1223 S Gear Ave Ste 309, West Burlington, IA 52655-1694 | 2014-04-02 |
| 1083976880 | Reid Phillip Turner | Ophthalmology | Wolfe Eye Clinic, 6200 Westown Parkway, Des Moines, IA 50266 | 2012-06-08 |
| 1043518368 | Robert Brian Goffstein | Ophthalmology | 403 North 7th Ave, Iowa City, IA 52245 | 2011-03-10 |
| 1992003677 | Virdi Eye Clinic of Iowa | Ophthalmology | 1015 13th Ave N, Clinton, IA 52732-3479 | 2011-03-04 |
| 1366604787 | Priya Gupta | Ophthalmology | 704 Westside Dr, Iowa City, IA 52246-4369 | 2008-06-26 |
| 1215124706 | Alex Kartvelishvili | Ophthalmology | 2225 Mormon Trek Blvd Ste 100, Iowa City, IA 52246-4407 | 2007-09-27 |
| 1306064324 | Brandt Michael Riley | Ophthalmology | Hwy 122, Mason City, IA 50402-1877 | 2007-04-23 |
| 1730280421 | Peter Rhee | Ophthalmology | 999 Home Plaza, Suite 101 Wolfe Eye Clinic, Waterloo, IA 50701 | 2006-09-26 |
| 1932200052 | Eye Associates Siouxland, P.l.c. | Ophthalmology | 2800 Pierce St Ste 404, Sioux City, IA 51104-3759 | 2006-09-25 |
| 1053416172 | Herbert Stanley Thompson | Ophthalmology | 2096 Kestrel Rdg Sw, Oxford, IA 52322-9111 | 2006-09-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.