NPIMap

Individual provider Active NPI

Bryan C Davis, M.D.

  • Family Medicine Physician
  • Winfield, KS
National Provider Identifier
1053425934
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-27652 Issued in KS
Practice address
1305 E 19TH Ave
Winfield, KS 67156-5201
Phone
(620) 221-9500
Fax
(620) 221-3700
NPI assigned
Aug 18, 2006
Last updated
Aug 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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 04-27652 KS Primary

Addresses

Primary practice location

1305 E 19TH Ave
Winfield, KS 67156-5201

Mailing address

1305 E 19TH Ave
Winfield, KS 67156-5201
Phone (620) 221-9500

Other identifiers 3

IdentifierTypeStateIssuer
130330OtherKSBC/BS OF KANSAS
100327700CMedicaidKS
336640OtherKSFIRSTGUARD INSURANCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050609001026 KS Practitioner - Family Practice 8022005818 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bryan C Davis MD PAGroup PAC ID 0446246235, 3 clinicians

Practice addresses (Care Compare)

1305 E 19TH Ave
Winfield, KS 67156-5201
Phone (620) 221-9500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions24
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-27652KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan C. Davis, M.D., P.a. Family Medicine CurrentSince Jun 26, 2000 Accepting new patients

Locations

1300 E 5th Ave
Winfield, KS 67156
Phone (620) 221-2300

1305 E 19th Ave
Winfield, KS 67156
Phone (620) 221-9500

3000 E 9th Ave
Winfield, KS 67156
Phone (316) 221-9500

Interoperability endpoints

  • Direct secure messaging: bryan.davis@khindirect.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IDCJBD/Endpoint/IDCJBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1053425934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 E 19TH AVE",
            "city": "WINFIELD",
            "state": "KS",
            "postal_code": "671565201",
            "telephone_number": "620-221-9500",
            "fax_number": "620-221-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 E 19TH AVE",
            "city": "WINFIELD",
            "state": "KS",
            "postal_code": "671565201",
            "telephone_number": "620-221-9500",
            "fax_number": "620-221-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRYAN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-27652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF KANSAS",
            "identifier": "130330",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100327700C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD INSURANCE",
            "identifier": "336640",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, KS

Sources for this page

Verify at the official NPI Registry.