Individual provider Active NPI

Diane Watkins Davis, M.D.

  • Otolaryngology Physician
  • Savannah, GA
National Provider Identifier
1285706309
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
24798 Issued in GA
Practice address
5201 Frederick St
Savannah, GA 31405-4501
Phone
(912) 351-3030
Fax
(912) 351-3039
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 24798 GA Primary

Addresses

Primary practice location

5201 Frederick St
Savannah, GA 31405-4501

Mailing address

5201 Frederick St
Savannah, GA 31405-4501
Phone (912) 351-3030

Other identifiers 1

IdentifierTypeStateIssuer
000264569AMedicaidGA

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
I20080623000335 GA Practitioner - Otolaryngology 2062583859 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24798GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Associates of Savannah, PC Otolaryngology CurrentSince Jul 11, 2016 Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Otolaryngology CurrentSince Jul 11, 2016 Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Otolaryngology Past Accepting new patients
Hearing Center at Dublin ENT PastSince Nov 24, 2024 Accepting new patients

Locations

5201 Frederick St
Savannah, GA 31405

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1285706309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DIANE",
        "middle_name": "WATKINS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "24798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000264569A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.