Individual provider Active NPI

Phillip Dennis Davis, PA-C

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1124092192
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002715 Issued in VA
Practice address
1849 Old Donation Pkwy
Virginia Beach, VA 23454
Phone
(757) 422-8476
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002715 VA Primary
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

1849 Old Donation Pkwy
Virginia Beach, VA 23454

Mailing address

1115 Boulders Pkwy Ste 200
North Chesterfield, VA 23225-4067
Phone (804) 560-5595

Other practice location 1

620 John Paul Jones Cir
Attn: Credentials/Staff Services
Portsmouth, VA 23708-2111
Phone (757) 953-1897

Other practice location 2

620 John Paul Jones Cir
Attn: Credentials/Staff Services
Portsmouth, VA 23708-2111
Phone (757) 953-1897

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pdavis17485@direct.orthovirginia.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080926000305 VA Practitioner - Physician Assistant 1850468224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002715VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc CurrentSince Dec 8, 2025 Accepting new patients
Orthovirginia, Inc. Past Accepting new patients

Locations

250 S Main St
Ste 224A
Blacksburg, VA 24060
Phone (540) 552-7122

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1124092192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PKWY STE 200",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-560-5595",
            "fax_number": "804-560-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 OLD DONATION PKWY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23454",
            "telephone_number": "757-422-8476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Cir",
            "address_2": "Attn: Credentials/Staff Services",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-1897",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 John Paul Jones Cir",
            "address_2": "Attn: Credentials/Staff Services",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-1897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PHILLIP",
        "middle_name": "DENNIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002715",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pdavis17485@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Phillip Davis direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "620 John Paul Jones Cir",
            "address_2": "Attn: Credentials/Staff Services",
            "city": "Portsmouth",
            "state": "VA",
            "country_code": "US",
            "postal_code": "237082111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.