Jay Michael Davis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G30021 Issued in CA

Practice address

3800 Janes Rd
Arcata, CA 95521-4742

Phone

(707) 826-8264

Fax

(707) 826-8292

NPI assigned

Jun 15, 2006

Last updated

Jun 17, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Six Rivers Emergency Physicians

  • Emergency Medicine Physician
  • Arcata, CA
  • NPI 1396786026
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1083658470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 JANES RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214742",
            "telephone_number": "707-822-3621",
            "fax_number": "707-826-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 JANES RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214742",
            "telephone_number": "707-826-8264",
            "fax_number": "707-826-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G30021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G300210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Darrough
• David S Gans MD
• Haley April Davies
• David Lloyd Davis, MD
• Emily Davis, MD
• Megan Maire Davis
• Samantha Day, LCSW
• Daybreak Behavioral Services, LLC
• Thomas Anthony Decarli
• Keith Lyle Delawder Jr.

• Family Medicine Physician in Arcata, CA
• Providers in Arcata, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.