NPIMap

Individual provider Active NPI

Jeffrey S Davis, MD

  • Urology Physician
  • Wichita, KS
National Provider Identifier
1073773008
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
04-36260 Issued in KS
Practice address
2626 N Webb Rd
Wichita, KS 67226-8110
Phone
(316) 636-6100
Fax
(316) 636-5813
NPI assigned
Jun 12, 2008
Last updated
Oct 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 26429 OK
Urology Physician 208800000X 04-36260 KS Primary

Addresses

Primary practice location

2626 N Webb Rd
Wichita, KS 67226-8110

Mailing address

2626 N Webb Rd
Wichita, KS 67226-8110
Phone (316) 636-6100

Other identifiers 1

IdentifierTypeStateIssuer
201076570AMedicaidKS

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
I20130821000990 KS Practitioner - Urology 1951544030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Nebraska College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wichita Urology Group PAGroup PAC ID 7214904499, 29 clinicians

Practice addresses (Care Compare)

2626 N Webb Rd
Wichita, KS 67226-8110
Phone (316) 636-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as individual
Promoting interoperability
96
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection14
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26429OKMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Urology Surgery Center LLC Past Accepting new patients
Kansas Spine Anesthesia Corporation PA PastSince Aug 1, 2013 Accepting new patients

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 7

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1073773008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "26429",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KS",
            "license": "04-36260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201076570A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.