Individual provider Active NPI

Robert W Davies, MD

  • Nephrology Physician
  • Walnut Creek, CA
National Provider Identifier
1215937933
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A42189 Issued in CA
Practice address
112 La Casa Via
Suite 210
Walnut Creek, CA 94598-3091
Phone
(925) 944-0351
Fax
(925) 944-1957
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A42189 CA Primary

Addresses

Primary practice location

112 La Casa Via
Suite 210
Walnut Creek, CA 94598-3091

Mailing address

112 La Casa Via
Suite 210
Walnut Creek, CA 94598-3091
Phone (925) 944-0351

Other identifiers 2

IdentifierTypeStateIssuer
CP2044OtherMEDICARE RAILROAD
GR0020610MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071130000387 CA Practitioner - Nephrology 1355430216 Practice locations: Walnut Creek, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A42189CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fresenius Medical Care Diablo Nephrology Clinics, LLC PastSince Jan 1, 2009 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215937933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "SUITE 210",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-944-0351",
            "fax_number": "925-944-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "SUITE 210",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-944-0351",
            "fax_number": "925-944-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A42189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CP2044",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0020610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.