NPIMap

Individual provider Active NPI

Laura J Davis, MD

  • Allergy Physician
  • Vancouver, WA
National Provider Identifier
1083607014
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
MD00043457 Issued in WA
Practice address
14508 NE 20TH Ave
#200
Vancouver, WA 98686-6418
Phone
(360) 695-8553
Fax
(360) 737-3713
NPI assigned
Aug 24, 2005
Reactivated
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X MD00043457 WA Primary

Addresses

Primary practice location

14508 NE 20TH Ave
#200
Vancouver, WA 98686-6418

Mailing address

14508 NE 20TH Ave
#200
Vancouver, WA 98686-6418
Phone (360) 695-8553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20180531002150 CO Practitioner - Internal Medicine 0749240158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Moab Regional Hospital Hospital, Moab, UT, CCN 461302
  • Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00043457WAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Hospital and Medical Center, Inc Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 6, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Jun 1, 2018 Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Jun 1, 2018 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 6, 2020 Accepting new patients
St. Mary'S Hospital and Medical Center, Inc. Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Organizations & group practices 7

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.

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1083607014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE",
            "address_2": "#200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866418",
            "telephone_number": "360-695-8553",
            "fax_number": "360-737-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE",
            "address_2": "#200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866418",
            "telephone_number": "360-695-8553",
            "fax_number": "360-737-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LAURA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-02-29",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "WA",
            "license": "MD00043457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.