Active NPI
John C Davis, M.D.
- Pediatrics Physician
- Bridgeton, MO
National Provider Identifier
1205875465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R7C02
- Practice address
- 12255 De Paul Dr
Suite 490
Bridgeton, MO 63044-2510 - Phone
- (314) 291-7766
- Fax
- (314) 291-7767
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R7C02 | MO | Primary |
Addresses
Primary practice location
12255 De Paul Dr
Suite 490
Bridgeton, MO 63044-2510
Mailing address
12255 De Paul Dr
Suite 490
Bridgeton, MO 63044-2510
Phone (314) 291-7766
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients | |
| SSM Depaul Medical Group, Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
-
dba DePaul Medical Group at Cross Keys
- Family Medicine Physician
- Florissant, MO
- NPI 1952312951
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1205875465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12255 DE PAUL DR",
"address_2": "SUITE 490",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442510",
"telephone_number": "314-291-7766",
"fax_number": "314-291-7767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12255 DE PAUL DR",
"address_2": "SUITE 490",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442510",
"telephone_number": "314-291-7766",
"fax_number": "314-291-7767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JOHN",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R7C02",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.