Individual provider Active NPI

John Patrick Davis, M.D.

  • Surgical Critical Care Physician
  • Charlottesville, VA
National Provider Identifier
1104116235
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
0101267055 Issued in VA
Practice address
1300 Jefferson Park Ave
Charlottesville, VA 22903-3363
Phone
(434) 924-2150
Fax
(434) 243-9433
NPI assigned
Apr 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 0101267055 VA Primary

Addresses

Primary practice location

1300 Jefferson Park Ave
Charlottesville, VA 22903-3363

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

2232 Wilborn Ave Ste C
South Boston, VA 24592-1662
Phone (434) 517-3910

Other practice location 2

1215 Lee St
Box 800681
Charlottesville, VA 22908-0816
Phone (434) 924-9307

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdavis105607@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191114002101 VA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3577792233 Reassigns benefits to 3 organizations
I20240130001416 CA Practitioner - General Surgery 3577792233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North County Trauma Associates Inc a Medical GroupGroup PAC ID 1759309735, 9 clinicians

Practice addresses (Care Compare)

838 Nordahl Rd
Suite 270
San Marcos, CA 92069-3596
Phone (760) 489-5955

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Health Medical Associates LTD CurrentSince Apr 4, 2022 Accepting new patients
University of Virginia Physicians Group CurrentSince Sep 4, 2019 Accepting new patients
Dominion Health Medical Assoc CurrentSince Apr 4, 2022 Accepting new patients
Urgent Specialty Associates PLLC CurrentSince Oct 15, 2021 Accepting new patients
Dominion Health Medical Assoc. Current Accepting new patients

Locations

1300 Jefferson Park Ave
Fl 4
Charlottesville, VA 22903
Phone (434) 924-5125

1300 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-2241

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

7101 Jahnke Rd
Ste 260
Richmond, VA 23225
Phone (804) 716-7755

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

2232 Wilborn Ave
Ste C
South Boston, VA 24592
Phone (434) 517-3910

2232 Wilborn Ave
Ste F
South Boston, VA 24592
Phone (434) 517-8095

Interoperability endpoints

  • Direct secure messaging: northcountytraumaassociates.johndavis@158576.advancedmd-direct.com
  • Direct secure messaging: jdavis105607@direct.healthsystem.virginia.edu

Organizations & group practices 6

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 2

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1104116235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JEFFERSON PARK AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033363",
            "telephone_number": "434-924-2150",
            "fax_number": "434-243-9433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 Wilborn Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "South Boston",
            "state": "VA",
            "postal_code": "245921662",
            "country_code": "US",
            "telephone_number": "434-517-3910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_2": "Box 800681",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-9307",
            "fax_number": "434-243-5791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "VA",
            "license": "0101267055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdavis105607@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1300 Jefferson Park Ave",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229033363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.