Individual provider Active NPI

Stephen M Davakis, M.D.

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1295712412
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-057108 Issued in OH
Practice address
4895 Olentangy River Rd
Suite 250
Columbus, OH 43214-1926
Phone
(614) 267-8371
Fax
(614) 262-0005
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-057108 OH Primary

Addresses

Primary practice location

4895 Olentangy River Rd
Suite 250
Columbus, OH 43214-1926

Mailing address

4895 Olentangy River Rd
Suite 250
Columbus, OH 43214-1926
Phone (614) 267-8371

Other identifiers 1

IdentifierTypeStateIssuer
0747142MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040817000006 OH Practitioner - Internal Medicine 2365415577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

4885 Olentangy River Rd
Columbus, OH 43214-1952
Phone (614) 326-5665

4885 Olentangy River Rd
Columbus, OH 43214-1953

4885 Olentangy River Rd
Columbus, OH 43214-1993

4895 Olentangy River Rd
Columbus, OH 43214-1185

625 Africa Rd
Westerville, OH 43082-0002

8050 E Main St
Suite 1200
Reynoldsburg, OH 43068-2575
Phone (614) 259-0923

Hospital & facility affiliations

  • National Church Residences Home and Community Serv Home health agency, Dublin, OH, CCN 368147
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-057108OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: sdavakis18997@copcp.medicity.net

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1295712412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD",
            "address_2": "SUITE 250",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141926",
            "telephone_number": "614-267-8371",
            "fax_number": "614-262-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD",
            "address_2": "SUITE 250",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141926",
            "telephone_number": "614-267-8371",
            "fax_number": "614-262-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVAKIS",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-057108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0747142",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.