Individual provider Active NPI

William R Davis, MD

  • Cardiovascular Disease Physician
  • Wauwatosa, WI
National Provider Identifier
1174585657
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
36170 Issued in WI
Practice address
2600 N Mayfair Rd
#950
Wauwatosa, WI 53226-1309
Phone
(414) 456-1123
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 36170 WI Primary

Addresses

Primary practice location

2600 N Mayfair Rd
#950
Wauwatosa, WI 53226-1309

Mailing address

2600 N Mayfair Rd
#950
Wauwatosa, WI 53226-1309
Phone (414) 456-1123

Other identifiers 1

IdentifierTypeStateIssuer
32085100MedicaidWI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36170WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Heart Scan, LLC Past Accepting new patients
Wisconsin Heart Group Cardiovascular Disease Past Accepting new patients
Wisconsin Heart Group Associates LLC Cardiovascular Disease Past Accepting new patients
William R Davis MD SC Cardiovascular Disease PastSince Oct 10, 2000 Accepting new patients

Organizations & group practices 4

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1174585657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "#950",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-456-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "#950",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-456-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "36170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32085100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.