Individual provider Active NPI

James D Davis, DPM

  • Foot & Ankle Surgery Podiatrist
  • Northglenn, CO
National Provider Identifier
1003898685
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
00520 Issued in CO
Practice address
11900 Grant St Ste 220
Northglenn, CO 80233-1117
Phone
(303) 673-1420
Fax
(303) 452-4398
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00520 CO Primary

Addresses

Primary practice location

11900 Grant St Ste 220
Northglenn, CO 80233-1117

Mailing address

11900 Grant St Ste 220
Northglenn, CO 80233-1117
Phone (303) 673-1420

Other identifiers 1

IdentifierTypeStateIssuer
88402045MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000154 CO Practitioner - Podiatry 7113999079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

11900 Grant St
Suite 220
Northglenn, CO 80233-1117
Phone (303) 673-1420

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00520COMDFoot & Ankle Surgery Podiatrist
520COMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 1, 2016 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 1, 2016 Accepting new patients
Intermountain Medical Group Denver, LLC Current Accepting new patients

Locations

11900 Grant St
Ste 220
Northglenn, CO 80233
Phone (303) 318-2112

9351 Grant St
Ste 490
Thornton, CO 80229
Phone (303) 451-5271

Organizations & group practices 3

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1003898685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 GRANT ST STE 220",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802331117",
            "telephone_number": "303-673-1420",
            "fax_number": "303-452-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 GRANT ST STE 220",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802331117",
            "telephone_number": "303-673-1420",
            "fax_number": "303-452-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "00520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88402045",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

Verify at the official NPI Registry.