Individual provider Active NPI

Jonathan Blair Davis, D.C.

  • Chiropractor
  • Gaithersburg, MD
National Provider Identifier
1154351609
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01303 Issued in MD
Practice address
16005 Comprint Cir
Gaithersburg, MD 20877-1318
Phone
(301) 963-6700
Fax
(301) 670-0306
NPI assigned
Jul 3, 2006
Last updated
May 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01303 MD Primary

Addresses

Primary practice location

16005 Comprint Cir
Gaithersburg, MD 20877-1318

Mailing address

16005 Comprint Cir
Gaithersburg, MD 20877-1318
Phone (301) 963-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110715000279 DC Practitioner - Chiropractic 5395913404 Reassigns benefits to 1 organization
Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
01303MDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jonathan B Davis PC Chiropractor CurrentSince Feb 5, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

16005 Comprint Cir
Gaithersburg, MD 20877
Phone (301) 963-6700

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1154351609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16005 COMPRINT CIR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771318",
            "telephone_number": "301-963-6700",
            "fax_number": "301-670-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16005 COMPRINT CIR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771318",
            "telephone_number": "301-963-6700",
            "fax_number": "301-670-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JONATHAN",
        "middle_name": "BLAIR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.