Jared Davis, D.O.
Individual provider Active NPI Urology Physician · Mount Clemens, MI
NPI 1114459476 · NPPES record last updated Sep 15, 2025
Key facts
- NPI
- 1114459476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 5101027013 (MI)
- Practice address
- 1000 Harrington St
Mount Clemens, MI 48043 - Phone
- (586) 493-8000
- NPI assigned
- Mar 28, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 18
Hospital & facility affiliations 6
Medicare Care Compare profile
- 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
- Munson Healthcare Otsego Memorial Hospital
Munson Healthcare Charlevoix Hospital
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
- Charlevoix Area Hospital
- Munson Healthcare Otsego Memorial Hospital
- Munson Medical Center
- Chippewa County War Memorial Hospital
- McLaren Northern Michigan
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 31 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230922002257 | MI | Practitioner - Urology | 6507135175 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101023055 | MI | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munson Healthcare Otsego Memorial Hospital | Urology | Current |
Accepting new patients |
| Munson Healthcare Charlevoix Hospital | Current |
Accepting new patients | |
| Munson Healthcare Otsego Memorial Hospital | Current | Accepting new patients | |
| Munson Healthcare Charlevoix Hospital | Urology | Current |
Accepting new patients |
| Munson Healthcare Otsego Memorial Hospital | Current |
Accepting new patients | |
| Munson Healthcare Charlevoix Hospital | Current | Accepting new patients | |
| Munson Healthcare Charlevoix Hospital | Past | 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
- jdavis485120@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 5101027013 | MI | Yes |
| 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
14695 Park Ave Ste A
Charlevoix, MI 49720-1920
Phone (231) 487-2270
Other practice location 2
829 N Center Ave Ste 260
Gaylord, MI 49735-1597
Phone (989) 731-6405
Other practice location 3
1619 Anderson Rd
Petoskey, MI 49770-9256
Phone (231) 417-6075
Other practice location 4
8881 M 119
Harbor Springs, MI 49740-9586
Phone (231) 487-2270
Other providers in Mount Clemens, MI
- William G Dallas
- Sarah Ashley Damer
- Leana Danesh
- Jacqueline Rena' Darby
- Christopher Davis
- Jeremy Davis
- Danielle Lucy Dawisha
- Karen F Dawson
- Stacy J Day
- Arsenio Vera De Leon
All providers in Mount Clemens, MI · Urology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.