Active NPI
Leon D Davis, M.D.
- Specialist
- Jacksonville, NC
National Provider Identifier
1144226408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 21336
- Practice address
- 245 Memorial Dr
Jacksonville, NC 28546-6333 - Phone
- (910) 353-4333
- Fax
- (910) 353-6529
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 21336 | NC | Primary |
Addresses
Primary practice location
245 Memorial Dr
Jacksonville, NC 28546-6333
Mailing address
245 Memorial Dr
Jacksonville, NC 28546-6333
Phone (910) 353-4333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8927452 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21336 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199836800000",
"number": "1144226408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 MEMORIAL DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466333",
"telephone_number": "910-353-4333",
"fax_number": "910-353-6529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 MEMORIAL DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466333",
"telephone_number": "910-353-4333",
"fax_number": "910-353-6529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LEON",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2008-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "21336",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8927452",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.