| Great River Medical Group | |
|
4626 Progress Dr Davenport IA 52807-3483 | |
| (563) 441-9100 | |
| (563) 441-9101 |
| Full Name | Great River Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 4626 Progress Dr, Davenport, Iowa |
| Authorized Official Name and Position | Lisa A Kopp (GENERAL PTR) |
| Authorized Official Contact | 5634419100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great River Medical Group 4626 Progress Dr Davenport IA 52807-3483 Ph: (563) 441-9100 | Great River Medical Group 4626 Progress Dr Davenport IA 52807-3483 Ph: (563) 441-9100 |
| NPI Number | 1750360251 |
|---|---|
| Provider Enumeration Date | 01/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5092766196 |
|---|---|
| Medicare Enrollment ID | O20050207000329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750360251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 03155 (Iowa) | Primary |
| Provider Name | Rupa R Bontu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407835994 PECOS PAC ID: 0446201545 Enrollment ID: I20050207000373 |
| Provider Name | Lisa Ann Kopp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821077322 PECOS PAC ID: 0345213740 Enrollment ID: I20050207000378 |
| Provider Name | Candyce L Ackland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255310744 PECOS PAC ID: 9537110630 Enrollment ID: I20050207000388 |
| Provider Name | Radhika Kolla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598744096 PECOS PAC ID: 2264483361 Enrollment ID: I20050208000483 |
Millennium Therapy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5260 Northwest Blvd, Suite 2, Davenport, IA 52806 Phone: 563-445-2400 Fax: 563-445-2404 | |
Renee D Lass Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4626 Progress Dr Ste B, Davenport, IA 52807 Phone: 563-359-3736 Fax: 563-359-0153 | |
Quad Cities Internal Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3509 Spring St, Suite 3, Davenport, IA 52807 Phone: 563-359-5011 Fax: 359-355-3438 | |
Community Health Care, Inc. Outreach Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 902 W 4th St, Davenport, IA 52802 Phone: 563-336-3000 Fax: 563-336-3125 | |
Genesis Health Group Davenport Clinic Health Home Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1820 W 3rd St, Davenport, IA 52802 Phone: 563-421-0500 Fax: 563-326-1901 | |
Quad Cities Pediatrics, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5510 Utica Ridge Rd Ste 100, Davenport, IA 52807 Phone: 563-424-2025 Fax: 563-424-2042 | |
Genesis Convenient Care Davenport Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 W 53rd St, Davenport, IA 52806 Phone: 563-421-3800 Fax: 563-421-3810 |