Individual provider Active NPI

Jeffrey William Davis, M.D.

  • Forensic Psychiatry Physician
  • Houston, TX
National Provider Identifier
1154765105
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
150139 Issued in CA
Practice address
9401 Southwest Fwy
Houston, TX 77074-1407
Phone
(713) 970-7000
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Q3354 TX
Forensic Psychiatry Physician 2084F0202X 150139 CA Primary

Addresses

Primary practice location

9401 Southwest Fwy
Houston, TX 77074-1407

Mailing address

10333 El Camino Real
Atascadero, CA 93422-5808
Phone (805) 468-2000

Other identifiers 1

IdentifierTypeStateIssuer
370540201MedicaidTX

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180807003289 CA Practitioner - Psychiatry 5991084089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at Houston, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of State HospitalsGroup PAC ID 9638174238, 275 clinicians

Practice addresses (Care Compare)

10333 El Camino Real
Atascadero State Hospital
Atascadero, CA 93423-7001
Phone (916) 651-8811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
150139CAMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Jun 5, 2018 Accepting new patients
Department of State Hospitals Current Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154765105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225808",
            "telephone_number": "805-468-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741407",
            "telephone_number": "713-970-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q3354",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "150139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370540201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.