Individual provider Active NPI

William Eugene Davis Jr., M.D.

  • Anesthesiology Physician
  • West Des Moines, IA
National Provider Identifier
1063498566
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
31229 Issued in IA
Practice address
4200 University Ave
Suite 300
West Des Moines, IA 50266-5945
Phone
(515) 401-1950
Fax
(515) 401-1955
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 31229 IA Primary

Addresses

Primary practice location

4200 University Ave
Suite 300
West Des Moines, IA 50266-5945

Mailing address

4200 University Ave
Suite 300
West Des Moines, IA 50266-5945
Phone (515) 401-1950

Other identifiers 6

IdentifierTypeStateIssuer
06009OtherIATRICARE PROVIDER #
050045048OtherIARAILROAD MEDICARE NUMBER
IA0168OtherIAJOHN DEERE PROVIDER #
54810OtherIABLUE SHIELD PROVIDER #
0141622MedicaidIA
5677OtherIAMIDLANDS PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31229IAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1063498566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 UNIVERSITY AVE",
            "address_2": "SUITE 300",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665945",
            "telephone_number": "515-401-1950",
            "fax_number": "515-401-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 UNIVERSITY AVE",
            "address_2": "SUITE 300",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665945",
            "telephone_number": "515-401-1950",
            "fax_number": "515-401-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "EUGENE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "31229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER #",
            "identifier": "06009",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "050045048",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE PROVIDER #",
            "identifier": "IA0168",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "54810",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141622",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS PROVIDER #",
            "identifier": "5677",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.