NPIMap

Individual provider Active NPI

Elizabeth Davies, MD

  • Family Medicine Physician
  • Waukesha, WI
National Provider Identifier
1164594016
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37977 Issued in WI
Practice address
717 W Moreland Blvd
Prohealth Care Medical Associates Moreland Family Medic
Waukesha, WI 53188-2432
Phone
(262) 542-9100
Fax
(262) 542-7366
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 4

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Homes of Wisconsin Inc 38 clinicians
Prohealth Medical Group Inc 475 clinicians

Practice addresses (Care Compare)

222 Park PL
Waukesha, WI 53186-4858
Phone (651) 631-6570

717 W Moreland Blvd
Waukesha, WI 53188-2432
Phone (262) 542-9100

Hospital & facility affiliations

  • Prohealth Home Care Home health agency, Waukesha, WI, CCN 527178
  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019001547 WI Practitioner - Family Practice 9830275882 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37977WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Prohealth Medical Group Inc Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Moreland Family Medicine Associates, S.C. CurrentSince Mar 27, 2008 Accepting new patients

Locations

18740 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 782-0230

717 W Moreland Blvd
Waukesha, WI 53188
Phone (262) 542-9100

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: edavies10789@direct.phci.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37977 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

717 W Moreland Blvd
Prohealth Care Medical Associates Moreland Family Medic
Waukesha, WI 53188-2432

Mailing address

717 W Moreland Blvd
Prohealth Care Medical Associates Moreland Family Medic
Waukesha, WI 53188-2432
Phone (262) 542-9100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2013.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1164594016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 W MORELAND BLVD",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES MORELAND FAMILY MEDIC",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882432",
            "telephone_number": "262-542-9100",
            "fax_number": "262-542-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 W MORELAND BLVD",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES MORELAND FAMILY MEDIC",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882432",
            "telephone_number": "262-542-9100",
            "fax_number": "262-542-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.