Individual provider Active NPI

Adriana Davis, D.O.

  • Family Medicine Physician
  • Burlington, NJ
National Provider Identifier
1225373111
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB09649000 Issued in NJ
Practice address
811 Sunset Rd
Burlington, NJ 08016-3645
Phone
(609) 877-4545
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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 25MB09649000 NJ Primary

Addresses

Primary practice location

811 Sunset Rd
Burlington, NJ 08016-3645

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

630 Mantua Pike
Woodbury, NJ 08096-3233
Phone (856) 812-2220

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adavis166951@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150821013872 NJ Practitioner - Family Practice 4880909696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

3242 Route 206
Bordentown, NJ 08505-4517

811 Sunset Rd
Burlington, NJ 08016-3645
Phone (609) 877-4545

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB09649000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine Current Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients
Virtua Willingboro Hospital Inc Past Accepting new patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

811 Sunset Rd
Burlington, NJ 08016
Phone (609) 387-9242

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

303 Lippincott Dr
Marlton, NJ 08053

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

200 Campbell Dr
Ste 102
Willingboro, NJ 08046
Phone (609) 877-4545

218A Sunset Rd
Willingboro, NJ 08046
Phone (609) 835-2900

Interoperability endpoints

  • FHIR API: https://epicproxy.et1017.epichosted.com/FHIRProxy/api/FHIR/R4

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1225373111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SUNSET RD",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080163645",
            "telephone_number": "609-877-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 Mantua Pike",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080963233",
            "country_code": "US",
            "telephone_number": "856-812-2220",
            "fax_number": "856-812-2221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ADRIANA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09649000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adavis166951@directvirtua.org",
            "affiliation": "N",
            "address_1": "811 Sunset Rd",
            "city": "Burlington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080163645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

Verify at the official NPI Registry.