Individual provider Active NPI

Labronz C Davis, MD

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1003857749
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35075818 Issued in OH
Practice address
2872 W Broad St
Columbus, OH 43204-2645
Phone
(614) 279-9905
Fax
(614) 279-0213
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35075818 OH Primary

Addresses

Primary practice location

2872 W Broad St
Columbus, OH 43204-2645

Mailing address

2872 W Broad St
Columbus, OH 43204-2645
Phone (614) 279-9905

Other identifiers 1

IdentifierTypeStateIssuer
2138154MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address labronz.davismd.p50@direct.ahni.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051007000890 OH Practitioner - Family Practice 2860302403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
American Health Network of Ohio, LLCGroup PAC ID 3173427721, 54 clinicians

Practice addresses (Care Compare)

2872 W Broad St
Columbus, OH 43204-2645
Phone (614) 279-9905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35075818OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Ohio, LLC Family Medicine CurrentSince May 11, 2009 Accepting new patients
American Health Network of Ohio, LLC CurrentSince May 11, 2009 Accepting new patients
American Health Network of Ohio, LLC Family Medicine Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
American Health Network of Ohio, LLC Family Medicine Past Accepting new patients

Locations

2872 W Broad St
Columbus, OH 43204
Phone (614) 274-9007

3180 E Broad St
Columbus, OH 43209
Phone (614) 231-2729

2500 Corporate Exchange Dr
Ste 100
Columbus, OH 43231
Phone (614) 794-4500

Interoperability endpoints

  • Direct secure messaging: ldavis210981@direct.optum.com

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1003857749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2872 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432042645",
            "telephone_number": "614-279-9905",
            "fax_number": "614-279-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2872 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432042645",
            "telephone_number": "614-279-9905",
            "fax_number": "614-279-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LABRONZ",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35075818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2138154",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "labronz.davismd.p50@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2872 W Broad St",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432042645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.