Individual provider Active NPI

Donn Marshall Davis, MD

  • Radiation Oncology Physician
  • Prescott, AZ
National Provider Identifier
1003899816
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
58993 Issued in AZ
Practice address
1100 Gail Gardner Way
Prescott, AZ 86305-1690
Phone
(928) 776-1040
Fax
(928) 776-1041
NPI assigned
Nov 25, 2005
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 39768 CO
Radiation Oncology Physician 2085R0001X G53197 CO
Radiation Oncology Physician 2085R0001X 58993 AZ Primary

Addresses

Primary practice location

1100 Gail Gardner Way
Prescott, AZ 86305-1690

Mailing address

PO Box 810221
Dallas, TX 75381-0221
Phone (520) 519-7700

Other practice location 1

7825 E Florentine Rd
Prescott Valley, AZ 86314-2217
Phone (928) 775-0810

Other identifiers 2

IdentifierTypeStateIssuer
75206307MedicaidCO
920007066OtherCORR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190920001060 AZ Practitioner - Radiation Oncology 0446342349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Nebraska College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Oncology Associates PCGroup PAC ID 9638067911, 42 clinicians
City of Hope Medical Group of Arizona LLCGroup PAC ID 2264593474, 159 clinicians

Practice addresses (Care Compare)

1100 Gail Gardner Way
Prescott, AZ 86305-1690
Phone (928) 776-1040

5430 Landmark LN
Prescott, AZ 86301-0019
Phone (928) 775-9430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39768COMDSpecialist
58993AZMDRadiation Oncology Physician
G53197COMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Oncology Associates PC Specialist CurrentSince Oct 1, 2019 Accepting new patients
City of Hope Medical Group of Arizona LLC Radiation Oncology CurrentSince Mar 4, 2026 Accepting new patients
HCA-Healthone, LLC Past Accepting new patients
Valley Radiotherapy Associates Medical Group Inc Specialist Past Accepting new patients

Locations

14200 W Celebrate Life Way
Goodyear, AZ 85338
Phone (623) 207-3000

1100 Gail Gardner Way
Prescott, AZ 86305
Phone (520) 776-1040

5430 Landmark Ln
Prescott, AZ 86301
Phone (928) 775-9430

3188 N Windsong Dr
Ste A
Prescott Valley, AZ 86314
Phone (928) 775-9430

7825 E Florentine Rd
Prescott Valley, AZ 86314
Phone (928) 775-0810

1760 E River Rd
Ste 350
Tucson, AZ 85718
Phone (520) 519-7720

2625 N Craycroft Rd
Ste 20
Tucson, AZ 85712
Phone (520) 324-2409

6897 Paysphere Cir
Chicago, IL 60674
Phone (480) 586-7542

Networks

  • NM HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: donn.davis@aoa.ikm.direct-ci.com
  • Direct secure messaging: mdavis@theusoncology.direct.varian.com

Organizations & group practices 4

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1003899816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810221",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753810221",
            "telephone_number": "520-519-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GAIL GARDNER WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051690",
            "telephone_number": "928-776-1040",
            "fax_number": "928-776-1041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7825 E Florentine Rd",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142217",
            "country_code": "US",
            "telephone_number": "928-775-0810",
            "fax_number": "928-775-0827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DONN",
        "middle_name": "MARSHALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "39768",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CO",
            "license": "G53197",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AZ",
            "license": "58993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75206307",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "920007066",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.