Brian Roy Davis

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R0706634 Issued in MN

Practice address

400 E 3Rd St
Duluth, MN 55805-1951

Phone

(218) 786-4626

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1174699375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRIAN",
        "middle_name": "ROY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R0706634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08924200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Davies, M.D.
• Matthew Thomas Davies, MD
• Andrew Davis, M.D.
• Anne Davis, RDH, DT
• Brad Jacob Davis
• Collin Ryan Davis, PHARMD
• Emily K Davis, APRN,CNM
• J. Joseph Davis
• Jefferson John Davis, DO
• Julianne Marie Davis, PSYD

• Certified Registered Nurse Anesthetist in Duluth, MN
• Providers in Duluth, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.