NPIMap

Individual provider Active NPI

Elijah Lorenzo Davis, D.P.M

  • Foot Surgery Podiatrist
  • Saint Joseph, MO
National Provider Identifier
1265545966
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
2208014928 Issued in MO
Practice address
5202 Faraon St.
Ste. a
St. Joseph, MO 64506-3480
Phone
(816) 271-1067
Fax
(816) 271-1071
NPI assigned
Aug 16, 2006
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 316 NE
Foot Surgery Podiatrist 213ES0131X 1200374 KS
Foot Surgery Podiatrist 213ES0131X 2208014928 MO Primary

Addresses

Primary practice location

5202 Faraon St.
Ste. a
St. Joseph, MO 64506-3480

Mailing address

5202 Faraon St.
Ste. a
St. Joseph, MO 64506-3480
Phone (816) 271-1067

Other practice location 1

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-0044

Other identifiers 4

IdentifierTypeStateIssuer
200575140AMedicaidKS
1265545966MedicaidMO
1265545966MedicaidIA
10026125400MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080827000476 MO Practitioner - Podiatry 9931275955 Reassigns benefits to 2 organizations
I20100715000692 KS Practitioner - Podiatry 9931275955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Centers of Missouri PCGroup PAC ID 7214934124, 3 clinicians

Practice addresses (Care Compare)

300 Utah St
Hiawatha, KS 66434-2326
Phone (785) 742-6286

407 NE 76TH Ter
Gladstone, MO 64118-1708
Phone (816) 436-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.47 of 100Reported as group
Quality
81.87
Promoting interoperability
99
Improvement activities
40
Cost
30.23

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
78.87

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
81.83
Promoting interoperability
99
Improvement activities
40
Cost
74.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions48
Removal of nail tissue1115
Removal or shaving of skin growth14
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
316NEMDRegistered Dietitian
1200374KSMDFoot Surgery Podiatrist
2208014928MOMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Truman Medical Center, Incorporated Current Accepting new patients
Truman Medical Center, Incorporated CurrentSince Jul 11, 2014 Accepting new patients
Truman Medical Center, Incorporated CurrentSince Jul 11, 2014 Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients
Ankle and Foot Centers of Missouri P.C. Foot Surgery CurrentSince Sep 1, 2008 Accepting new patients
Community Medical Center, Inc Past Accepting new patients

Locations

300 Utah St
Hiawatha, KS 66434
Phone (785) 742-6286

705 N College St
Albany, MO 64402
Phone (660) 726-3941

2301 Holmes St
Kansas City, MO 64108

407 NE 76th Ter
Kansas City, MO 64118
Phone (816) 436-7900

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

191 Iowa Blvd
Trenton, MO 64683
Phone (660) 358-5700

Interoperability endpoints

  • Direct secure messaging: elijah.davis@direct.mymlc.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1265545966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 FARAON ST.",
            "address_2": "STE. A",
            "city": "ST. JOSEPH",
            "state": "MO",
            "postal_code": "645063480",
            "telephone_number": "816-271-1067",
            "fax_number": "816-271-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 FARAON ST.",
            "address_2": "STE. A",
            "city": "ST. JOSEPH",
            "state": "MO",
            "postal_code": "645063480",
            "telephone_number": "816-271-1067",
            "fax_number": "816-271-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-404-0044",
            "fax_number": "816-404-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELIJAH",
        "middle_name": "LORENZO",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NE",
            "license": "316",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "KS",
            "license": "1200374",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MO",
            "license": "2208014928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200575140A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265545966",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265545966",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026125400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.