NPIMap

Individual provider Active NPI

Cedrice N. Davis, M.D.

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1215060819
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
048768 Issued in GA
Practice address
2520 Windy Hill Rd SE
Suite 301
Marietta, GA 30067-8664
Phone
(770) 952-1032
Fax
(770) 952-8579
NPI assigned
Mar 13, 2007
Last updated
Mar 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 048768 GA Primary

Addresses

Primary practice location

2520 Windy Hill Rd SE
Suite 301
Marietta, GA 30067-8664

Mailing address

2520 Windy Hill Rd SE
Suite 301
Marietta, GA 30067-8664
Phone (770) 952-1032

Other identifiers 1

IdentifierTypeStateIssuer
00958801AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000735 GA Practitioner - Family Practice 0244303568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urban Family Practice Associates, P.C.Group PAC ID 4486645108, 3 clinicians

Practice addresses (Care Compare)

2520 Windy Hill Rd
Suite 301
Marietta, GA 30067-8653
Phone (770) 952-1032

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Family Practice CurrentSince Aug 14, 2000 Accepting new patients
Urban Family Practice Associates, P.C. Family Medicine CurrentSince Aug 14, 2000 Accepting new patients

Locations

2520 Windy Hill Rd SE
Ste 301
Marietta, GA 30067
Phone (770) 952-1032

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1215060819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 WINDY HILL RD SE",
            "address_2": "SUITE 301",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678664",
            "telephone_number": "770-952-1032",
            "fax_number": "770-952-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 WINDY HILL RD SE",
            "address_2": "SUITE 301",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678664",
            "telephone_number": "770-952-1032",
            "fax_number": "770-952-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CEDRICE",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "048768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00958801A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.