Randel C Davis, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2484 Issued in AZ

Practice address

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443

Phone

(602) 249-0212

NPI assigned

Nov 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Cep America- Arizona, PC

  • Emergency Medicine Physician
  • Chandler, AZ
  • NPI 1780202804
  Medicare reassignment NPD
• Emergency Physician Professional Association, LTD.

  • Emergency Medicine Physician
  • Glendale, AZ
  • NPI 1396769972
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1265415392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15623 S 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488632",
            "telephone_number": "480-460-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152443",
            "telephone_number": "602-249-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RANDEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "2484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET - GROUP #",
            "identifier": "AW1436",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH - GROUP #",
            "identifier": "453051001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - GROUP #",
            "identifier": "860373636",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0728670",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078817",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE - GROUP #",
            "identifier": "3981220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Davis, PA-C
• Nicole M Davis, FNP-BC
• Nytisha Davis, PHLEBOTOMIST
• Pamela F. Davis, PSY. D
• Patricia Davis, FNP-C
• Roy I Davis, M.D.
• Sara Gabrielle Davis, SLP
• Shannon Davis, RDH
• Sheila Shelly Marie Davis
• Stefanie M Davis, WHNP

• Emergency Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.