Individual provider Active NPI

Ross Davis, M.D.

  • Vascular Surgery Physician
  • Winston Salem, NC
National Provider Identifier
1235312679
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2008-00948 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-4151
NPI assigned
Dec 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2008-00948 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081231000466 NC Practitioner - Vascular SurgeryPractitioner - General Surgery 6901968890 Reassigns benefits to 1 organization
I20101007001401 AL Practitioner - General Surgery 6901968890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Alabama School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion19
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008-00948NCMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority CurrentSince Sep 1, 2015 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Wake Forest University Health Sciences CurrentSince Feb 27, 2017 Accepting new patients
WRMC Hospital Operating Corporation Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1206 Columbia Hwy
Dothan, AL 36301
Phone (334) 677-5986

112 Haven Dr
Ste 1
Dothan, AL 36301
Phone (334) 673-0049

1118 Ross Clark Cir
Ste 500
Dothan, AL 36301
Phone (334) 794-4159

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: rdavis2755170@carolinashealthcaresystem.direct-ci.com

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": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1235312679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROSS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-07",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2008-00948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.