Individual provider Active NPI

Richard P Davis, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Beavercreek, OH
National Provider Identifier
1093920514
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
35.134895 Issued in OH
Practice address
2510 Commons Blvd Ste 160
Beavercreek, OH 45431-3834
Phone
(937) 426-0049
Fax
(937) 431-8140
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.134895 OH
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 01062747A IN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 35.134895 OH Primary

Addresses

Primary practice location

2510 Commons Blvd Ste 160
Beavercreek, OH 45431-3834

Mailing address

2510 Commons Blvd Ste 160
Beavercreek, OH 45431-3834
Phone (937) 425-4010

Other identifiers 1

IdentifierTypeStateIssuer
0358463MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rdavis588622@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190612004019 OH Practitioner - Internal MedicinePractitioner - Endocrinology 9335320951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Texas a & M University System, HSC, College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1989 Miamisburg Centerville Rd
Suite 201
Centerville, OH 45459-3858
Phone (937) 401-7575

2510 Commons Blvd
Beavercreek, OH 45431-3834

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Internal Medicine CurrentSince Dec 29, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2510 Commons Blvd
Ste 160
Beavercreek, OH 45431
Phone (937) 425-4010

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

2115 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-6920

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

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.

Hospital & facility affiliations 5

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1093920514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 160",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313834",
            "telephone_number": "937-425-4010",
            "fax_number": "937-425-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 160",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313834",
            "telephone_number": "937-426-0049",
            "fax_number": "937-431-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RICHARD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.134895",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "01062747A",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "35.134895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0358463",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdavis588622@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2510 Commons Blvd Ste 160",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454313834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2510 Commons Blvd Ste 160",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454313834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.