John L Davis Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301103346 Issued in MI

Practice address

4328 Buteo Dr
Traverse City, MI 49684-7239

Phone

(269) 998-9297

NPI assigned

Jun 10, 2013

Last updated

Sep 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jdavis3@direct.mhc.net

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.

• Munson Healthcare Grayling

  dba Roscommon Community Health Center

  • Family Medicine Physician
  • Roscommon, MI
  • NPI 1598131617
  NPD (past)

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1184062465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 BUTEO DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4328 BUTEO DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847239",
            "telephone_number": "269-998-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301103346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdavis3@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1250 E Michigan Ave",
            "city": "Grayling",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497387074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott B Davidson, MD
• Steven P Davidson, MD
• Pecol Davis-Green
• Eric Bradley Davis, R.PH.
• Hannah Davis, LMT
• Leah Claire Davis, D.O.
• Meghan Visnick Davis, CNMW
• Patricia Davis, CNPF
• Rebecca Louise Davis, PHARM.D.
• Christina Annette Davison

• Family Medicine Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.