Active NPI
Jimmie Davis Jr.
- Surgical Assistant
- Arlington, TX
National Provider Identifier
1225563018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 3623
- Practice address
- 1109 Bell St
Arlington, TX 76001-7116 - Phone
- (817) 899-5682
- NPI assigned
- Apr 28, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 3623 | TX | Primary |
Addresses
Primary practice location
1109 Bell St
Arlington, TX 76001-7116
Mailing address
1109 Bell St
Arlington, TX 76001-7116
Phone (817) 899-5682
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3623 | TX | MD | Surgical Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jay Davis Enterprise LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493337600000",
"number": "1225563018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 BELL ST",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760017116",
"telephone_number": "817-899-5682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 BELL ST",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760017116",
"telephone_number": "817-899-5682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JIMMIE",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-28",
"last_updated": "2017-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "3623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.