Individual provider Active NPI

William Scott Davis, D.P.M.

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1235547233
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0000745 Issued in CO
Practice address
10 S Riverside PLZ
Ste 19 East
Chicago, IL 60606-3728
Phone
(773) 770-0140
NPI assigned
Jul 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0000745 CO Primary

Addresses

Primary practice location

10 S Riverside PLZ
Ste 19 East
Chicago, IL 60606-3728

Mailing address

10 S Riverside PLZ
Ste 19 East
Chicago, IL 60606-3728

Other identifiers 2

IdentifierTypeStateIssuer
P01592111OtherCORAILROAD MEDICARE
25803328MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140926000429 CO Practitioner - Podiatry 8426278409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Podiatry Group PCGroup PAC ID 3971412677, 131 clinicians

Practice addresses (Care Compare)

1660 Allison St
Lakewood, CO 80214-6023
Phone (303) 232-7177

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1977
Removal or shaving of skin growth676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000745COMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Podiatrist CurrentSince Dec 16, 2015 Accepting new patients

Locations

1200 Village Rd
Carbondale, CO 81623
Phone (970) 963-1500

2425 Teller Ave
Grand Junction, CO 81501
Phone (970) 210-7879

1660 Allison St
Lakewood, CO 80214
Phone (303) 232-7177

1330 Sidney Ave
Sterling, CO 80751
Phone (970) 522-4888

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1235547233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S RIVERSIDE PLZ",
            "address_2": "STE 19 EAST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S RIVERSIDE PLZ",
            "address_2": "STE 19 EAST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063728",
            "telephone_number": "773-770-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "0000745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01592111",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25803328",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.