NPIMap

Individual provider Active NPI

John K Davis, DO

  • Emergency Medicine Physician
  • Bullhead City, AZ
National Provider Identifier
1093796104
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3192 Issued in AZ
Practice address
2735 Silver Creek Rd
Bullhead City, AZ 86442-7924
Phone
(928) 763-2273
NPI assigned
Nov 7, 2005
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 3192 AZ Primary

Addresses

Primary practice location

2735 Silver Creek Rd
Bullhead City, AZ 86442-7924

Mailing address

2390 Satterfield Dr
Pocatello, ID 83201-7905
Phone (208) 238-0235

Other identifiers 4

IdentifierTypeStateIssuer
39-87220OtherAZEVERCARE GROUP
392241MedicaidAZ
AW1436OtherAZHEALTHNET GROUP
AZ0728670OtherAZBLUECROSS/BLUESHIELD GRP

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients
Lake Mead Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Emergency Physician Professional Association, LTD. Emergency Medicine Past Accepting new patients
Twin Valley Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Emcare Physician Providers Inc Emergency Medicine Past Accepting new patients
Exigence Arizona LLC Past Accepting new patients
Payson Emergency Physicians, P.C. Emergency Medicine Past Accepting new patients
Exigence Medical of Binghamton PLLC Past Accepting new patients
Winnemucca Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Coyote Creek Emergency Physicians Emergency Medicine Past Accepting new patients

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1093796104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 SATTERFIELD DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832017905",
            "telephone_number": "208-238-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 SILVER CREEK RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427924",
            "telephone_number": "928-763-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "3192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE GROUP",
            "identifier": "39-87220",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "392241",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GROUP",
            "identifier": "AW1436",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD GRP",
            "identifier": "AZ0728670",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.