Rupa R Bontu (NPI# 1407835994, PAC ID# 0446201545) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1407835994 |
| PAC ID by PECOS | 0446201545 |
| Professional Enrollment ID | I20050207000373 |
| Full Name | Rupa R Bontu |
| Organization Legal Name | GREAT RIVER MEDICAL GROUP |
| Address |
4626 Progress Dr C Davenport IA 52807-3485 |
| Phone Number | 5634419100 |
| Gender | F |
| Credential | MD |
| Graduation Year | 1979 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 5092766196 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 160104 | TRINITY - BETTENDORF |
| 140280 | TRINITY - ROCK ISLAND |
| 160033 | GENESIS MEDICAL CENTER-DAVENPORT |
| 161313 | GENESIS MEDICAL CENTER-DEWITT |
| 140275 | GENESIS HLTH SYSTEM DBA GENESIS MDL CTR-ILLINI |
| Address | Phone | Organization |
|---|---|---|
| 4626 Progress Dr C, Davenport, IA 52807-3485 | 5634419100 | GREAT RIVER MEDICAL GROUP |
| Organization Legal Name | GREAT RIVER MEDICAL GROUP |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Candyce L Ackland | Family Medicine | Great River Medical Group | 4626 Progress Dr C, Davenport, IA 52807-3485 |
| Radhika Kolla | Internal Medicine | Great River Medical Group | 4626 Progress Dr C, Davenport, IA 52807-3485 |
| Lisa Kopp | Internal Medicine | Great River Medical Group | 4626 Progress Dr C, Davenport, IA 52807-3485 |
| Street Address |
4626 PROGRESS DR C |
| City | DAVENPORT |
| State | IA |
| Zip | 52807-3485 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Candyce L Ackland | Family Medicine | Great River Medical Group | 4626 Progress Dr C, Davenport, IA 52807-3485 |
| Radhika Kolla | Internal Medicine | Great River Medical Group | 4626 Progress Dr C, Davenport, IA 52807-3485 |
| Lisa Kopp | Internal Medicine | Great River Medical Group | 4626 Progress Dr C, Davenport, IA 52807-3485 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristine F Oswald | Clinical Social Worker | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Karen K Maves | Allergy/immunology | 2112 E 38th St, Davenport, IA 52807-1135 | |
| Robin R Peterson | Psychologist, Clinical | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Robert L Koupal | Clinical Social Worker | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Wayne M Sliwa | Psychologist, Clinical | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Judy H Prochaska | Clinical Social Worker | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Julia Marmion | Psychologist, Clinical | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Jolene C Atkinson | Clinical Social Worker | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Robert Andrew Gillespie | Psychologist, Clinical | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Jessica M Schultz | Psychologist, Clinical | Psychology Health Group | 2102 E 38th St, Davenport, IA 52807-1135 |
| Find all physicians in zip 52807 | |||
| City | DAVENPORT |
| Zip Code | 52807 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | DAVENPORT + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Rupa R Bontu.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.