Roger W Davis, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

30919 Issued in CO

Practice address

3676 Parker Blvd
Suite 230
Pueblo, CO 81008-2212

Phone

(719) 553-2206

Fax

(719) 553-2226

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Roger W. Davis, MD, LLC

  • Orthopaedic Surgery Physician
  • Pueblo, CO
  • NPI 1124274949
  NPD (past) Authorized official
• Open MRI of Pueblo, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Pueblo, CO
  • NPI 1922190487
  NPD (past)
• Southern Colorado Clinic PC

  • Clinic/Center
  • Pueblo, CO
  • NPI 1598371056
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1124058094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9000",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810089000",
            "telephone_number": "719-553-2206",
            "fax_number": "719-553-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "address_2": "SUITE 230",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-2206",
            "fax_number": "719-553-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROGER",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "30919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01309194",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124058094",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Ranea Davis, RN
• Lauren Davis, MA, LPCC
• Lori Davis
• Malinda Lee Davis, RN
• Mark Davis, PA-C
• Scott D. Davis
• Theodore W Davis, D.C.
• Kenneth Michael Davison, MSW
• Muath Dawod, M.D.
• Dana Dawson, LPN

• Orthopaedic Surgery Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Orthopaedic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.