Individual provider Active NPI

Amy Davis, DO, MS, MACP, FAAHPM

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Bryn Mawr, PA
National Provider Identifier
1063536902
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
OS013419 Issued in PA
Practice address
16 N Bryn Mawr Ave #386
Bryn Mawr, PA 19010-0347
Phone
(610) 520-1677
NPI assigned
Mar 17, 2007
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS013419 PA
Addiction Medicine (Internal Medicine) Physician 207RA0401X OS013419 PA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X OS013419 PA Primary

Addresses

Primary practice location

16 N Bryn Mawr Ave #386
Bryn Mawr, PA 19010-0347

Mailing address

16 N Bryn Mawr Ave #386
Bryn Mawr, PA 19010-0347
Phone (610) 520-1677

Other identifiers 1

IdentifierTypeStateIssuer
1021954500001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
OS013419PAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1063536902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N BRYN MAWR AVE #386",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190100347",
            "telephone_number": "610-520-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N BRYN MAWR AVE #386",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190100347",
            "telephone_number": "610-520-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMY",
        "credential": "DO, MS, MACP, FAAHPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-17",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS013419",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "PA",
            "license": "OS013419",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "PA",
            "license": "OS013419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021954500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.