Individual provider Active NPI

Jared Davis, D.O.

  • Urology Physician
  • Mount Clemens, MI
National Provider Identifier
1114459476
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
5101027013 Issued in MI
Practice address
1000 Harrington St
Mount Clemens, MI 48043
Phone
(586) 493-8000
NPI assigned
Mar 28, 2017
Last updated
Sep 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 5101027013 MI Primary
Urology Physician 208800000X 5101023055 MI

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043

Mailing address

1000 Harrington Boulevard
Mount Clemens, MI 48043

Other practice location 1

829 N Center Ave Ste 260
Gaylord, MI 49735-1597
Phone (989) 731-6405

Other practice location 2

1619 Anderson Rd
Petoskey, MI 49770-9256
Phone (231) 417-6075

Other practice location 3

8881 M 119
Harbor Springs, MI 49740-9586
Phone (231) 487-2270

Other practice location 4

14695 Park Ave Ste A
Charlevoix, MI 49720-1920
Phone (231) 487-2270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230922002257 MI Practitioner - Urology 6507135175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

829 N Ctr Ave
260 MHC Omh Medical Group Urology
Gaylord, MI 49735-1597
Phone (989) 731-6405

8881 M
Suite 119
Harbor Springs, MI 49740-9586
Phone (231) 487-2270

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101023055MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Charlevoix Hospital Urology CurrentSince Aug 6, 2023 Accepting new patients
Munson Healthcare Charlevoix Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Aug 6, 2023 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Urology CurrentSince Aug 6, 2023 Accepting new patients
Munson Healthcare Charlevoix Hospital CurrentSince Aug 6, 2023 Accepting new patients

Locations

14651 W Upright St
Charlevoix, MI 49720
Phone (231) 547-4477

14695 Park Ave
Ste A
Charlevoix, MI 49720
Phone (231) 547-2812

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Ste 260
Gaylord, MI 49735
Phone (989) 731-6405

8881 M 119
Harbor Springs, MI 49740
Phone (231) 347-5400

1619 Anderson Rd
Petoskey, MI 49770
Phone (231) 417-6000

Interoperability endpoints

  • Direct secure messaging: jdavis485120@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1114459476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON BOULEVARD",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "fax_number": "586-493-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 N Center Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351597",
            "country_code": "US",
            "telephone_number": "989-731-6405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1619 Anderson Rd",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497709256",
            "country_code": "US",
            "telephone_number": "231-417-6075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8881 M 119",
            "address_purpose": "LOCATION",
            "city": "Harbor Springs",
            "state": "MI",
            "postal_code": "497409586",
            "country_code": "US",
            "telephone_number": "231-487-2270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14695 Park Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlevoix",
            "state": "MI",
            "postal_code": "497201920",
            "country_code": "US",
            "telephone_number": "231-487-2270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JARED",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101027013",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101023055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.