Michael L Davis, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

08327 Issued in MS

Practice address

2100 Highway 61 N
Vicksburg, MS 39183-8211

Phone

(601) 630-9755

NPI assigned

Jun 28, 2006

Last updated

Jan 28, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GFEFCD

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.

• Vicksburg Nephrology LLC

  • Nephrology Physician
  • Vicksburg, MS
  • NPI 1013337658

  LA

  Medicare reassignment NPD Authorized official
• Michael L Davis M.D., P.a.

  • Nephrology Physician
  • Vicksburg, MS
  • NPI 1891945234
  Authorized official Same address or phone
• Dermatology and Skin Cancer Clinic, P.a.

  • Specialist
  • Vicksburg, MS
  • NPI 1598819450
  NPD (past)
• Vicksburg Clinic LLC

  • Surgery Physician
  • Vidalia, LA
  • NPI 1629279054
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1033147442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820328",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391820328",
            "telephone_number": "601-630-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-630-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "08327",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "10165R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116318",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1319422",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rudella Davenport
• Tyla Davenport
• David M Halinski MD PC (Vicksburg Pulmonary Clinic)
• Christie Davis
• Leslie Erin Davis, PA
• Sherita Davis
• Donald Allan Dearman, NURSE PRACTITIONER
• Jennifer Decker
• Megann Price Dees, PA-C
• Jessica Delk

• Nephrology Physician in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Nephrology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.