Davis Dermatology, PA

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

ME51662 Issued in FL

Legal business name

DAVIS DERMATOLOGY, PA

Practice address

504 S Orange St
New Smyrna Beach, FL 32168-7319

Phone

(386) 423-2218

NPI assigned

Nov 28, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Valerie Davis, MDNPI 1457332819

Title

Owner

Phone

(386) 423-2218

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Valerie G. Davis, M.D.

  • Procedural Dermatology Physician
  • New Smyrna Beach, FL
  • NPI 1457332819
  Medicare reassignment Care Compare group NPD Authorized official
• Ariel Powers, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1093731523
  Medicare reassignment Care Compare group
• Theresa Holt, APRN

  • Nurse Practitioner
  • Orlando, FL
  • NPI 1902482722
  Medicare reassignment NPD
• Heather L Crawford, PA-C

  • Physician Assistant
  • Daytona Beach, FL
  • NPI 1871588830
  Medicare reassignment
• Kiran Babu Lachireddy, PA

  • Physician Assistant
  • The Villages, FL
  • NPI 1821470477
  Medicare reassignment
• Jessica N Lynch, PA-C

  • Physician Assistant
  • Emporia, KS
  • NPI 1649844820

  FL

  Medicare reassignment

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1104330224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S ORANGE ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687319",
            "telephone_number": "386-423-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S ORANGE ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687319",
            "telephone_number": "386-423-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-423-2218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME51662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047966700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crown Assisted Living LLC
• Austin Culver
• Philip Blaine Dahlquist, DMD
• Elisa Irene Davidow-Carter, LMHC
• Keiauna J Davidson
• Anthony J. Davis, D.O.
• James R Davis, DDS
• Valerie G. Davis, M.D.
• Daisy Mae Pila De la Pena, APRN
• Danielle De Negreiros

• Procedural Dermatology Physician in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Procedural Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.