Individual provider Active NPI

Robert A Davis, MD

  • Diagnostic Radiology Physician
  • Greensboro, GA
National Provider Identifier
1083665541
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
58162 Issued in GA
Practice address
1201 Siloam Rd
Greensboro, GA 30642-2811
Phone
(706) 453-7331
Fax
(706) 389-3885
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 58162 GA Primary

Addresses

Primary practice location

1201 Siloam Rd
Greensboro, GA 30642-2811

Mailing address

PO Box 7638
Athens, GA 30604-7638
Phone (706) 453-7331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58162GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Good Samaritan Hospital, Inc. Current Accepting new patients
Central Kentucky Radiology PLLC Diagnostic Radiology Past Accepting new patients

Locations

1201 Siloam Rd
Greensboro, GA 30642
Phone (706) 453-7331

5401 Lake Oconee Pkwy
Greensboro, GA 30642
Phone (706) 453-7331

Organizations & group practices 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1083665541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7638",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306047638",
            "telephone_number": "706-453-7331",
            "fax_number": "706-389-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SILOAM RD",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306422811",
            "telephone_number": "706-453-7331",
            "fax_number": "706-389-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "58162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.