Mark L Davis, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

007480 Issued in AZ

Practice address

1739 E Beverly Ave Ste 102
Kingman, AZ 86409-3593

Phone

(928) 681-8693

Fax

(928) 681-8694

NPI assigned

Jun 10, 2005

Last updated

Apr 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MI, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Orthopedic Surgery

Education

Michigan State University College of Osteopathic Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marlette Regional HospitalGroup PAC ID 3971408121, shared by 10 NPIs, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
• Marlette Regional Hospital Hospital, Marlette, MI, CCN 231330
• Hills & Dales General Hospital Hospital, Cass City, MI, CCN 231316

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-myrecord.cerner.com/r4/i-zcCbJ35X2O5bJkqEF8dvUIAeQf3o9y/
• Direct secure messaging: mark.davis.1@8233.direct.athenahealth.com
• Direct secure messaging: mdavis164466@direct.covenanthealthcare.com

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.

• HRMC, LLC

  dba Cancer Care of Western Arizona

  • Hematology & Oncology Physician
  • Lake Havasu City, AZ
  • NPI 1003139387

  Multi-Specialty

  Medicare reassignment NPD
• Kingman Healthcare, Inc

  dba Kingman Regional Medical Center

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  Multi-Specialty

  Medicare reassignment NPD
• Deckerville Community Hospital, Inc.

  • Family Medicine Physician
  • Deckerville, MI
  • NPI 1164540555

  Multi-Specialty

  Medicare reassignment NPD
• Hills & Dales General Hospital, Inc.

  • Critical Access Hospital
  • Cass City, MI
  • NPI 1154367001

  Multi-Specialty

  Medicare reassignment NPD
• Marlette Regional Hospital

  • Rural Health Clinic/Center
  • Marlette, MI
  • NPI 1235333931

  Multi-Specialty

  Medicare reassignment NPD
• Marlette Regional Hospital

  • Emergency Medicine Physician
  • Marlette, MI
  • NPI 1598840498

  Multi-Specialty

  Medicare reassignment NPD
• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684

  Multi-Specialty

  Medicare reassignment NPD
• Deckerville Community Hospital Inc

  • Critical Access Hospital
  • Deckerville, MI
  • NPI 1619095718
  Medicare reassignment
• Marlette Regional Hospital

  • Critical Access Hospital
  • Marlette, MI
  • NPI 1346325214
  Medicare reassignment
• HRMC, LLC

  dba Urgent Care of HRMC

  • Internal Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1932610482

  Multi-Specialty

  NPD
• Kingman Healthcare, Inc

  dba KRMC Urgent Care

  • Urgent Care Clinic/Center
  • Kingman, AZ
  • NPI 1760703805
  NPD
• Kingman Healthcare, Inc

  dba KRMC Community Pharmacy

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hills & Dales General Hospital, Inc.

  • Critical Access Hospital
  • Cass City, MI
  • NPI 1154367001
  Care Compare affiliation
• Hills & Dales General Hospital, Inc.

  dba Aspire Hill Street Clinic

  • Psychiatry Physician
  • Cass City, MI
  • NPI 1952120859

  Hospital

  Care Compare affiliation
• Marlette Regional Hospital

  dba Aspire Medical Center-Marlette

  • General Practice Physician
  • Marlette, MI
  • NPI 1043911449

  Hospital

  Care Compare affiliation
• Marlette Regional Hospital

  • Clinic/Center
  • Marlette, MI
  • NPI 1073385456

  Hospital

  Care Compare affiliation
• Marlette Regional Hospital

  • Family Medicine Physician
  • Marlette, MI
  • NPI 1225495013

  Hospital

  Care Compare affiliation
• Marlette Regional Hospital

  • Critical Access Hospital
  • Marlette, MI
  • NPI 1346325214
  Care Compare affiliation
• Marlette Regional Hospital

  dba Aspire Angle Street Clinic

  • Family Medicine Physician
  • Marlette, MI
  • NPI 1730988999

  Hospital

  Care Compare affiliation
• Marlette Regional Hospital

  • Family Medicine Physician
  • Marlette, MI
  • NPI 1740062462

  Hospital

  Care Compare affiliation
• Residential Home Health and Hospice, Inc.

  • Home Health Agency
  • Lapeer, MI
  • NPI 1316054810
  Care Compare affiliation
• Residential Home Health and Hospice, Inc.

  • Community Based Hospice Care Agency
  • Lapeer, MI
  • NPI 1831395243

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1083618615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 E BEVERLY AVE STE 102",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "928-681-8693",
            "fax_number": "928-681-8694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Lake Lansing Rd",
            "address_2": "Suite B1",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489123753",
            "country_code": "US",
            "telephone_number": "517-371-3407",
            "fax_number": "517-371-1366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Beech St Ste B",
            "address_purpose": "LOCATION",
            "city": "Tawas City",
            "state": "MI",
            "postal_code": "487638314",
            "country_code": "US",
            "telephone_number": "989-362-9859",
            "fax_number": "989-362-9862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101012747",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "007480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "200C313650",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE NETWORK",
            "identifier": "200C31650",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "300040412",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "200000001852",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "2053302675",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4837808",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trinh Thuc Dao
• Cynthia Mae Darlington
• Amanda Marie Daumke, PHARM.D.
• Bomi Y Davis, DO
• Christine Marie Davis, M.D..
• Mustafa Kamari Davis, M.D.
• Rebecca S Davis, RPH
• Timothy L Davis, LPC
• Troy Allen Davison
• Adam Gregory Dawson, D.O.

• Orthopaedic Surgery Physician in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.