Individual provider Active NPI

Amy B Davis, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Corinth, MS
National Provider Identifier
1184755308
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
18218 Issued in MS
Practice address
121 Pratt Dr Ste 1a
Corinth, MS 38834-6026
Phone
(662) 286-0088
Fax
(662) 286-0067
NPI assigned
Mar 8, 2007
Last updated
Jan 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 18218 MS Primary

Addresses

Primary practice location

121 Pratt Dr Ste 1a
Corinth, MS 38834-6026

Mailing address

401 Alcorn Dr
Ste 2C
Corinth, MS 38834-9073
Phone (662) 286-0088

Other identifiers 1

IdentifierTypeStateIssuer
08033823MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20040315000332 MS Practitioner - Emergency Medicine 7618866856 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18218MSMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Physician Services, Inc CurrentSince Apr 1, 2014 Accepting new patients
Magnolia Regional Health Center CurrentSince Sep 1, 2003 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Jan 1, 2018 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Ear Nose & Throat Current Accepting new patients
Magnolia Regional Health Center CurrentSince Sep 1, 2003 Accepting new patients
Premier Radiology, Inc PastSince Jan 1, 2018 Accepting new patients

Locations

3704 Highway 72 W
Corinth, MS 38834
Phone (662) 286-1499

401 Alcorn Dr
Ste 2C
Corinth, MS 38834
Phone (662) 286-9255

401 Alcorn Dr
Ste 2D
Corinth, MS 38834
Phone (662) 293-1565

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

703 Alcorn Dr
Ste 109
Corinth, MS 38834
Phone (662) 286-1499

Interoperability endpoints

  • Direct secure messaging: amydavis@magnolia.medalliesdirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1184755308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ALCORN DR",
            "address_2": "STE 2C",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349073",
            "telephone_number": "662-286-0088",
            "fax_number": "662-286-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PRATT DR STE 1A",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346026",
            "telephone_number": "662-286-0088",
            "fax_number": "662-286-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MS",
            "license": "18218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08033823",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.