Mark A Davis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2841 Issued in SC

Practice address

2611 Forest Dr Ste 200
Columbia, SC 29204-2371

Phone

(803) 779-3263

Fax

(803) 779-3207

NPI assigned

Feb 9, 2006

Last updated

Apr 20, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321
  Medicare reassignment
• Prisma Health Medical Group-Midlands

  • Orthopaedic Surgery Physician
  • Columbia, SC
  • NPI 1346761897
  NPD
• Prisma Health Medical Group-Midlands

  dba PH Dentistry

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD
• Palmetto Health

  dba Palmetto Health Orthopedics

  • Orthopaedic Surgery Physician
  • Columbia, SC
  • NPI 1780005827
  NPD (past)
• Palmetto Health

  dba Sumter Orthopaedic Surgery

  • Orthopaedic Surgery Physician
  • Sumter, SC
  • NPI 1942668074
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1073586186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042371",
            "telephone_number": "803-779-3263",
            "fax_number": "803-779-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042371",
            "telephone_number": "803-779-3263",
            "fax_number": "803-779-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA2841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kizzy L Davis
• Lahoma Arronette Davis
• Lateek Davis, TRANSPORTATION
• Leigh Norris Davis, APRN
• Maranda Brown Davis, HAIRLOSS SPECIALIST
• Martha Ann Davis, RD, LD
• Mary G Davis, NP
• Mathew Chad Davis, APRN
• Melissa Davis, FNP-BC
• Micheala Davis

• Physician Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.