Individual provider Active NPI

Chanty Denise Davis, M.D.

  • Nephrology Physician
  • Macon, GA
National Provider Identifier
1215951298
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
050097 Issued in GA
Practice address
165 Emery Hwy
Suite 100
Macon, GA 31217-3666
Phone
(478) 741-2150
Fax
(478) 741-2208
NPI assigned
Jul 26, 2006
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 050097 GA
Nephrology Physician 207RN0300X 050097 GA Primary

Addresses

Primary practice location

165 Emery Hwy
Suite 100
Macon, GA 31217-3666

Mailing address

165 Emery Hwy
Suite 100
Macon, GA 31217-3666
Phone (478) 741-2150

Other identifiers 5

IdentifierTypeStateIssuer
P00408060OtherGARAILROAD MEDICARE
000911039DMedicaidGA
000911039EMedicaidGA
CJ4042OtherGARAILROAD MEDICARE GROUP
000911039CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040712000803 GA Practitioner - Nephrology 6608853312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Minnesota Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians
Hospital Medicine Services of Ga LLCGroup PAC ID 2062997505, 90 clinicians

Practice addresses (Care Compare)

1170 Cleveland Ave
East Point, GA 30344-3615
Phone (404) 466-1170

200 Industrail Blvd
Dublin, GA 31021-2981
Phone (478) 275-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
050097GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Aug 20, 2019 Accepting new patients
Dublin Nephrology Associates LLC Nephrology PastSince Jan 28, 2004 Accepting new patients

Locations

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

Organizations & group practices 3

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 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1215951298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 EMERY HWY",
            "address_2": "SUITE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173666",
            "telephone_number": "478-741-2150",
            "fax_number": "478-741-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 EMERY HWY",
            "address_2": "SUITE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173666",
            "telephone_number": "478-741-2150",
            "fax_number": "478-741-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHANTY",
        "middle_name": "DENISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "050097",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "050097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00408060",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000911039D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000911039E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CJ4042",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000911039C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.