Individual provider Active NPI

Jessica Peavy Enneking Davis, M.D.

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1083970560
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD042052 Issued in DC
Practice address
2150 Pennsylvania Ave NW
The GW Medical Faculty Associates
Washington, DC 20037-3201
Phone
(202) 741-3000
NPI assigned
Apr 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD042052 DC Primary

Addresses

Primary practice location

2150 Pennsylvania Ave NW
The GW Medical Faculty Associates
Washington, DC 20037-3201

Mailing address

2150 Pennsylvania Ave NW
The GW Medical Faculty Associates
Washington, DC 20037-3201
Phone (202) 741-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240213000327 VA Practitioner - Gastroenterology 7315250099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Virginia School of Medicine, 2012
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

5875 Bremo Rd
Suite 712
Richmond, VA 23226-1928
Phone (804) 288-8900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Nov 17, 2024 Accepting new patients
Bon Secours-Richmond Community Hospital LLC Current Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Nov 17, 2024 Accepting new patients
Bon Secours-Richmond Community Hospital LLC CurrentSince Feb 7, 2024 Accepting new patients
Bon Secours-Richmond Community Hospital LLC CurrentSince Feb 7, 2024 Accepting new patients

Locations

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5875 Bremo Rd
Ste 712
Richmond, VA 23226
Phone (804) 285-9416

Organizations & group practices 5

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 6

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": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1083970560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "address_2": "THE GW MEDICAL FACULTY ASSOCIATES",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "202-741-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "address_2": "THE GW MEDICAL FACULTY ASSOCIATES",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "202-741-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "middle_name": "PEAVY ENNEKING",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD042052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.