Organization Active NPI

Vijayselwyn Davis Dhas MD

  • Obstetrics & Gynecology Physician
  • St Augustine, FL
National Provider Identifier
1053614305
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME104834 Issued in FL
Legal business name
VIJAYSELWYN DAVIS DHAS MD
Doing business as
OB-GYN OF ST AUGUSTINE
Practice address
301 Health Park Blvd
Ste 219
St Augustine, FL 32086-5793
Phone
(904) 824-9444
Fax
(904) 819-9594
NPI assigned
Dec 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Authorized official

Name
Vihayselwyn Davis Dhas, MD
Title
Owner
Phone
(904) 824-9444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X ME104834 FL Primary

Addresses

Primary practice location

301 Health Park Blvd
Ste 219
St Augustine, FL 32086-5793

Mailing address

PO Box 840262
St Augustine, FL 32080-0262
Phone (904) 824-9444

Other identifiers 1

IdentifierTypeStateIssuer
002960100MedicaidFL

Other names 1

  • OB-GYN OF ST AUGUSTINE Doing business as

National Provider Directory

National Provider Directory

Locations

301 Health Park Blvd
St Augustine, FL 32086
Phone (304) 829-6441

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1053614305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840262",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320800262",
            "telephone_number": "904-824-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD",
            "address_2": "STE 219",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865793",
            "telephone_number": "904-824-9444",
            "fax_number": "904-819-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAYSELWYN DAVIS DHAS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "DHAS",
        "authorized_official_first_name": "VIHAYSELWYN",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-824-9444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME104834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002960100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OB-GYN OF ST AUGUSTINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.