Active NPI
Glenda Omayra Davila, M.D.
- General Practice Physician
- Barceloneta, PR
National Provider Identifier
1255459004
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Mar 20, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 14855
- Practice address
- Calle 9 Buzon 10
Bo. Magueyes
Barceloneta, PR 00617-0822 - Phone
- (787) 846-7534
- NPI assigned
- Mar 27, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 14855 | PR | Primary |
Addresses
Primary practice location
Calle 9 Buzon 10
Bo. Magueyes
Barceloneta, PR 00617-0822
Mailing address
PO Box 822
Barceloneta, PR 00617-0822
Phone (787) 846-7534
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14855 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255459004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 822",
"city": "BARCELONETA",
"state": "PR",
"postal_code": "006170822",
"telephone_number": "787-846-7534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE 9 BUZON 10",
"address_2": "BO. MAGUEYES",
"city": "BARCELONETA",
"state": "PR",
"postal_code": "006170822",
"telephone_number": "787-846-7534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVILA",
"first_name": "GLENDA",
"middle_name": "OMAYRA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "14855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barceloneta, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.