NPIMap

Emily Davis, MD

Individual provider Active NPI Family Medicine Physician · Arcata, CA

NPI 1003430174 · NPPES record last updated Apr 25, 2024

Key facts

NPI
1003430174
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
AD185523 (CA)
Practice address
1150 Foster Ave
Arcata, CA 95521-5986
Phone
(707) 822-2481
NPI assigned
Jun 3, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Door Community Health Centers (113 clinicians)

Practice addresses (Care Compare)

1150 Foster Ave
Arcata, CA 95521-5986
Phone (707) 826-8610

2200 Tydd St
Eureka, CA 95501-1284
Phone (707) 441-1624

3750 Rohnerville Rd
Fortuna, CA 95540-3118
Phone (707) 725-6101

550 E Washington Blvd
Crescent City, CA 95531-8160
Phone (707) 465-6925

770 10TH St
Arcata, CA 95521-6210
Phone (707) 826-8610

Hospital & facility affiliations

  • Providence St Joseph Hospital Hospital · Eureka, CA · CCN 050006
  • Mad River Community Hospital Hospital · Arcata, CA · CCN 050028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231019003049 CA Practitioner - Family Practice 3678993813 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AD185523CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers Single Specialty Current Accepting new patients
Open Door Community Health Centers Current
since Aug 26, 2023		 Accepting new patients
Open Door Community Health Centers Single Specialty Current Accepting new patients
Open Door Community Health Centers Single Specialty Current Accepting new patients
Open Door Community Health Centers Current
since Aug 26, 2023		 Accepting new patients
Open Door Community Health Centers Single Specialty Current Accepting new patients

Locations

1150 Foster Ave
Arcata, CA 95521
Phone (707) 822-2481

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

1275 8th St
Arcata, CA 95521

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636

2200 Tydd St
Eureka, CA 95501
Phone (707) 269-7051

1644 Central Ave
McKinleyville, CA 95519
Phone (707) 839-3068

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16258/brand/6/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/madrmc-58191942
  • FHIR API: https://fhir-myrecord.cerner.com/r4/1c1a9f5d-79fb-4003-8c99-6287771c0404/
  • Direct secure messaging: edavis649786@direct.ochin.org
  • Direct secure messaging: edavis324926@direct.ochin.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X AD185523 CA Yes

Addresses

Primary practice location

1150 Foster Ave
Arcata, CA 95521-5986

Mailing address

1150 Foster Ave
Arcata, CA 95521-5986

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 25, 2024.

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1003430174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 FOSTER AVE",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 FOSTER AVE",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215986",
            "telephone_number": "707-822-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EMILY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "AD185523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcata, CA

All providers in Arcata, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.