Individual provider Active NPI

John Charles Davis Sr., PA-C

  • Physician Assistant
  • Humble, TX
National Provider Identifier
1073820072
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01488 Issued in TX
Practice address
7120 FM 1960 Rd E
Humble, TX 77346-2702
Phone
(281) 783-8162
NPI assigned
Sep 12, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA01488 TX
Surgical Physician Assistant 363AS0400X PA01488 TX
Health Educator 174H00000X PA01488 TX
Student in an Organized Health Care Education/Training Program 390200000X PA01488 TX
Physician Assistant 363A00000X PA01488 TX Primary

Addresses

Primary practice location

7120 FM 1960 Rd E
Humble, TX 77346-2702

Mailing address

2925 Briarpark Dr Ste 575
Houston, TX 77042-3776
Phone (832) 626-2842

Other practice location 1

4003 Alshire Dr
Spring, TX 77373-8811
Phone (832) 526-5578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20141210002260 TX Practitioner - Physician Assistant 0042432965 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emrd Ventures, PLLCGroup PAC ID 8123481066, 6 clinicians

Practice addresses (Care Compare)

1240 E Palm Valley Blvd
Round Rock, TX 78664-3202
Phone (512) 733-9100

1331 Northpark Dr
Kingwood, TX 77339-1636
Phone (281) 359-5330

1501 W Church St
Suite 800
Livingston, TX 77351-0056
Phone (936) 327-0191

15320 Hwy 105 W
Suite 120
Montgomery, TX 77356-2602
Phone (936) 582-5660

2705 Broadway St
Suite 101
Pearland, TX 77581-4915
Phone (281) 412-0508

6825 Spencer Hwy
Pasadena, TX 77505-1770
Phone (281) 741-0070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Next Level MV LLC CurrentSince Aug 1, 2022 Accepting new patients
Ucp Physicians of Central Texas, PLLC CurrentSince Feb 23, 2023 Accepting new patients
Texas Em-I Medical Services PA Physician Assistant CurrentSince Mar 2, 2015 Accepting new patients
St Joseph Emergency Physicians PLLC CurrentSince Aug 6, 2014 Accepting new patients
Nluc PLLC CurrentSince Aug 1, 2022 Accepting new patients
Texas Em-I Medical Services PA Physician Assistant CurrentSince Mar 2, 2015 Accepting new patients
Escobar-Davis Medical Management PLLC Medical Past Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

7710 Garth Rd
Ste A
Baytown, TX 77521

1246 N FM 3083 Rd W
Ste B
Conroe, TX 77304

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

7120 FM 1960 Rd E
Humble, TX 77346
Phone (281) 358-0655

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

8325 Broadway St
Ste 220
Pearland, TX 77581
Phone (281) 873-8162

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

Interoperability endpoints

  • Direct secure messaging: john.davispac.p6@direct.nextcare.nextgenshare.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1073820072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 BRIARPARK DR STE 575",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770423776",
            "telephone_number": "832-626-2842",
            "fax_number": "832-626-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 FM 1960 RD E",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462702",
            "telephone_number": "281-783-8162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4003 Alshire Dr",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773738811",
            "country_code": "US",
            "telephone_number": "832-526-5578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Prof.",
        "name_suffix": "Sr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-12",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA01488",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA01488",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "TX",
            "license": "PA01488",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "PA01488",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.