Glenn Scott Davis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

350-72747 Issued in OH

Practice address

98 State St
Proctorville, OH 45669-8163

Phone

(740) 886-9403

Fax

(740) 446-5153

NPI assigned

Feb 7, 2007

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 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Internal Medicine

Education

West Virginia University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
• St Marys Medical Center Hospital, Huntington, WV, CCN 510007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glenn.davis.1@17389.direct.athenahealth.com

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.

• Holzer Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Gallipolis, OH
  • NPI 1508817248
  Medicare reassignment Care Compare group NPD
• G. Scott Davis, M.D., Inc.

  • Internal Medicine Physician
  • Ironton, OH
  • NPI 1518089051
  NPD (past) Authorized official
• I Path LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Gallipolis, OH
  • NPI 1942525563
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holzer Hospital Foundation

  • Rural Acute Care Hospital
  • Gallipolis, OH
  • NPI 1942256888
  Care Compare affiliation
• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1124168406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-886-9370",
            "fax_number": "740-446-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 STATE ST",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456698163",
            "telephone_number": "740-886-9403",
            "fax_number": "740-446-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GLENN",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "350-72747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "1073272",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000189349",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICAID - UNISON",
            "identifier": "000000241476",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110217004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICAID MOLINA",
            "identifier": "2056840",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012072",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2056840",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glenn.davis.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "98 State St",
            "city": "Proctorville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456698163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bradley James Curtis
• Grace Kathlynne Curtis
• Jeremy Clifton Cuzzourt, MD
• Celeste M Dalton
• James S. Darlington, D.D.S.
• Daystar Services LLC
• Jami Nell Dean, CPHT
• Ruby Deyoung, LPN
• Deeidra S Edmunds, LICSW
• Teresa Gaye Edwards

• Internal Medicine Physician in Proctorville, OH
• Providers in Proctorville, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.