Genesis Development

Genesis Development is a healthcare organization registered as Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jefferson, IA, holding Type 2 (organization) NPI 1003887639 since 2006. The authorized official on file is Terry Johnson, Ceo.

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NPI 1003887639
Entity type Organization (Type 2)
Legal business name Genesis Development
Practice address 401 W MCKINLEY ST, Jefferson, IA, 50129
Phone 5153863017
Fax 5153864642
Enumeration date 2006-01-31
Last updated in NPPES 2010-05-05

Authorized official

Name Terry Johnson
Title Ceo
Phone 5153863017

Taxonomy & classification

Taxonomy code Specialty Primary License State
251C00000X Developmentally Disabled Services Day Training Agency Secondary
320600000X Intellectual and/or Developmental Disabilities Residential Treatment Facility Secondary
320800000X Mental Illness Community Based Residential Treatment Facility Secondary
311ZA0620X Adult Care Home Facility Secondary
3104A0630X Assisted Living Facility (Behavioral Disturbances) Secondary
3104A0625X Assisted Living Facility (Mental Illness) Secondary
251S00000X Community/Behavioral Health Agency Secondary
320900000X Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Other identifiers

Identifier Type State Issuer
0465401 Medicaid IA
0465419 Medicaid IA
1232363 Medicaid IA
0280529 Medicaid IA
0465435 Medicaid IA
0428656 Medicaid IA
0465393 Medicaid IA
0243121 Medicaid IA
0465534 Medicaid IA
0110726 Medicaid IA
0232363 Medicaid IA
0245829 Medicaid IA
0890007 Medicaid IA
15-08-003 Other IA NON POS AGREEMENT NUMBER
0245811 Medicaid IA
0894865 Medicaid IA
1245811 Medicaid IA
0290353 Medicaid IA
Copy-ready billing details
Provider: Genesis Development
NPI: 1003887639
Taxonomy: 320900000X (Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility)
Address: 401 W MCKINLEY ST, Jefferson, IA, 50129

Providers at this address

NPI Name Type Specialty Location
1942327283 Genesis Development Organization Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Jefferson, IA

Verify this record

Cross-check NPI 1003887639 against the authoritative CMS record: view Genesis Development on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Who is the authorized official for Genesis Development?
NPPES lists Terry Johnson (Ceo) as the authorized official for this organization.
What is the NPI number for Genesis Development?
The NPI for Genesis Development is 1003887639, a Type 2 (organization) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-09. Provider record last updated 2010-05-05.