Kevin Wesley Davis, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

064355 Issued in GA

Practice address

775 Poplar Rd
Suite 250
Newnan, GA 30265-8300

Phone

(770) 400-4610

Fax

(678) 423-2739

NPI assigned

Sep 23, 2005

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

Credentials

Doctor of Medicine

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.

• Carolina Surgical Clinic, LLC

  • Clinic/Center
  • Newberry, SC
  • NPI 1992830632
  NPD (past) Authorized official
• Papp Clinic Laboratory

  • Clinical Medical Laboratory
  • Newnan, GA
  • NPI 1932353042
  NPD (past)
• Newberry Surgical Associates PA

  • Vascular Surgery Physician
  • Newberry, SC
  • NPI 1063499226
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1194711283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD",
            "address_2": "SUITE 250",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658300",
            "telephone_number": "770-400-4610",
            "fax_number": "678-423-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD",
            "address_2": "SUITE 250",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658300",
            "telephone_number": "770-400-4610",
            "fax_number": "678-423-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KEVIN",
        "middle_name": "WESLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "064355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764840117A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carleigh Elizabeth Davis, RBT
• Jasmine Davis
• Jaylyn Janay Davis
• Kathryn Elizabeth Davis, D.C.
• Kennedy Lynn Davis
• Lee Davis, PA-C
• Ralph D Davis, DC
• Sarah Dawson, MA, BCBA
• Terica Dawson
• Towauna Daya

• Surgery Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.