Active NPI
Brian Wayne Davis, M.D.
- Critical Care Medicine (Internal Medicine) Physician
- Missoula, MT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- 18582
- Practice address
- 4625 Bordeaux Blvd
Missoula, MT 59808-8686 - Phone
- (859) 533-3471
- NPI assigned
- Nov 1, 2006
- Last updated
- Apr 28, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | LL29140 | SC | |
| Internal Medicine Physician | 207R00000X | 256390 | NY | |
| Internal Medicine Physician | 207R00000X | 18582 | MT | |
| Internal Medicine Physician | 207R00000X | MD2016-0024 | NM | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 256390 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 18582 | MT | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD2016-0024 | NM | |
| Pulmonary Disease Physician | 207RP1001X | 256390 | NY | |
| Pulmonary Disease Physician | 207RP1001X | 18582 | MT | |
| Pulmonary Disease Physician | 207RP1001X | MD2016-0024 | NM |
Addresses
Primary practice location
4625 Bordeaux Blvd
Missoula, MT 59808-8686
Mailing address
4625 Bordeaux Blvd
Missoula, MT 59808-8686
Phone (859) 533-3471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- University of Kentucky College of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone (361) 881-3000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18582 | MT | MD | Internal Medicine Physician |
| LL29140 | SC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gulf Coast Intensivists, PLLC | Critical Care Medicine | Current | Accepting new patients |
| University Health System Inc | Current | Accepting new patients | |
| University Health System, Inc | Internal Medicine | Current | Accepting new patients |
| University Health System, Inc | Pulmonary Disease | Current | Accepting new patients |
| Christus Spohn Health System Corporation | Past | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
1940 Alcoa Hwy
Ste E120
Knoxville, TN 37920
Phone (865) 305-8040
1940 Alcoa Hwy
Ste E210
Knoxville, TN 37920
Phone (865) 524-7471
9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142
600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511
Organizations & group practices 6
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Corpus Christi, TX
- NPI 1104509199
-
dba UT Internal Medicine Pellissippi
- Internal Medicine Physician
- Knoxville, TN
- NPI 1790738763
-
dba University Thoracic Surgeons
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Knoxville, TN
- NPI 1306609748
-
dba University Pulmonary and Critical Care
- Pulmonary Disease Physician
- Knoxville, TN
- NPI 1811250228
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
-
dba CHRISTUS Spohn Hospital Corpus Christi
- General Acute Care Hospital
- Corpus Christi, TX
- NPI 1689641680
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CHRISTUS Spohn Hospital Corpus Christi
- General Acute Care Hospital
- Corpus Christi, TX
- NPI 1689641680
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493337600000",
"number": "1205913506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4625 BORDEAUX BLVD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598088686",
"telephone_number": "859-533-3471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4625 BORDEAUX BLVD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598088686",
"telephone_number": "859-533-3471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BRIAN",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2017-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "LL29140",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "256390",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MT",
"license": "18582",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NM",
"license": "MD2016-0024",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NY",
"license": "256390",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MT",
"license": "18582",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NM",
"license": "MD2016-0024",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "256390",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MT",
"license": "18582",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NM",
"license": "MD2016-0024",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.