Individual provider Active NPI

Lucas Howard Davis, M.D.

  • Internal Medicine Physician
  • Augusta, GA
National Provider Identifier
1265660799
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
067289 Issued in GA
Practice address
1120 15TH Street
Augusta, GA 30912-0004
Phone
(706) 724-6100
NPI assigned
Jun 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL31759 SC
Family Medicine Physician 207Q00000X 67289 GA
Internal Medicine Physician 207R00000X 067289 GA Primary

Addresses

Primary practice location

1120 15TH Street
Augusta, GA 30912-0004

Mailing address

1499 Walton Way
Ste 1400
Augusta, GA 30901-2603
Phone (706) 724-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20130409000437 GA Practitioner - Family Practice 4486890811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Now Urgent Care, LLC 11 clinicians

Practice addresses (Care Compare)

104 N Belair Rd
Suite 101
Evans, GA 30809-6503
Phone (706) 799-5664

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL31759SCMDFamily Medicine Physician
067289GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Nov 2, 2013 Accepting new patients
Med Now Urgent Care, LLC Family Medicine CurrentSince Feb 11, 2013 Accepting new patients
Au Medical Associates Inc CurrentSince Nov 2, 2013 Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients

Locations

2851 Washington Rd
Augusta, GA 30909
Phone (706) 922-6578

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

104 N Belair Rd
Ste 101
Evans, GA 30809
Phone (706) 799-5664

469 Lewiston Rd
Grovetown, GA 30813
Phone (706) 922-6578

1067 Peachtree St
Louisville, GA 30434
Phone (478) 625-7000

Organizations & group practices 4

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1265660799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 WALTON WAY",
            "address_2": "STE 1400",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012603",
            "telephone_number": "706-724-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH STREET",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-724-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LUCAS",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL31759",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "67289",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "067289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.