Jeff P Davis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-30240 Issued in KS

Practice address

12115 E 21St St N
Suite 107
Wichita, KS 67206-3567

Phone

(316) 440-7000

Fax

(316) 440-7006

NPI assigned

Jun 9, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 6, 2016 through Dec 6, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Emergency Services of Kansas, PA

  • Internal Medicine Physician
  • Newton, KS
  • NPI 1104864503

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1285675413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12115 E 21ST ST N",
            "address_2": "SUITE 107",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063567",
            "telephone_number": "316-440-7000",
            "fax_number": "316-440-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12115 E 21ST ST N",
            "address_2": "SUITE 107",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063567",
            "telephone_number": "316-440-7000",
            "fax_number": "316-440-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEFF",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-30240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darren Davis
• Debra D Davis, P.A.
• Elizabeth Anne Davis
• Hilary R Davis, PTA
• James A Davis, DENTAL HYGENTIST
• Jeffrey S Davis, MD
• Jennifer M. Davis, NP-C
• Joe Davis
• Jonathon Samuel Davis, DO
• Joshua Warren Davis, D.D.S.

• All providers in Wichita, KS
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.