Dr James E Davis Jr

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007432 Issued in IL

Legal business name

DR JAMES E DAVIS JR

Practice address

3411 N Woodford St
Decatur, IL 62526-2861

Phone

(217) 877-0312

Fax

(217) 877-0397

NPI assigned

Mar 7, 2017

Organization subpart

No

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

Authorized official

Name

James E Davis, O.D.

Title

Owner

Phone

(217) 877-0312

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1083154264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 N WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262861",
            "telephone_number": "217-877-0312",
            "fax_number": "217-877-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 N WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262861",
            "telephone_number": "217-877-0312",
            "fax_number": "217-877-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JAMES E DAVIS JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-877-0312",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007432",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Donaldson
• Carla Maria Donnelly, LPC
• Aurelia Dothager, LCSW
• Jerry Lynn Douglas, LCSW
• Mohammad Douleh, DMD
• Tessa Drake
• Stephan R Draughan, PHARMD
• Joe Drew, LPC
• Julie Lynn Drew, M.A. CCC-SLP
• DRS Graham & Graham LTD

• Optometrist in Decatur, IL
• Providers in Decatur, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.