Individual provider Active NPI

Clayton Davis, DO

  • Urology Physician
  • Bishop, CA
National Provider Identifier
1164927927
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
20A20823 Issued in CA
Practice address
150 Pioneer LN
Bishop, CA 93514-2556
Phone
(760) 873-5811
NPI assigned
Mar 26, 2018
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Urology Physician 208800000X 20A20823 CA Primary

Addresses

Primary practice location

150 Pioneer LN
Bishop, CA 93514-2556

Mailing address

150 Pioneer LN
Bishop, CA 93514-2556

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
I20230726000594 CA Practitioner - Urology 4981955549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rocky Vista University College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Inyo Healthcare DistrictGroup PAC ID 8921992090, 104 clinicians

Practice addresses (Care Compare)

150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A20823CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Inyo Associates CurrentSince Aug 1, 2023 Accepting new patients
Northern Inyo Healthcare District CurrentSince Aug 1, 2023 Accepting new patients
Northern Inyo Healthcare District CurrentSince Nov 1, 2025 Accepting new patients

Locations

150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136

152 Pioneer Ln
Ste F
Bishop, CA 93514
Phone (760) 872-1606

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1164927927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142556",
            "telephone_number": "760-873-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CLAYTON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "20A20823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

Verify at the official NPI Registry.