Individual provider Active NPI

Catherine D Davis, PA/AA

  • Anesthesiologist Assistant
  • Macon, GA
National Provider Identifier
1306814249
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
002988 Issued in GA
Practice address
624 Bellgrove PT
Macon, GA 31220-7621
Phone
(478) 731-4009
NPI assigned
Mar 8, 2006
Last updated
Dec 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 002988 GA Primary

Addresses

Primary practice location

624 Bellgrove PT
Macon, GA 31220-7621

Mailing address

624 Bellgrove PT
Macon, GA 31220-7621
Phone (478) 731-4009

Other identifiers 8

IdentifierTypeStateIssuer
100000477CMedicaidGA
100000477GMedicaidGA
P00097133OtherGAPALMETTO GBA
580628385OtherGATRICARE
P00422622OtherGARAILROAD MEDICARE
100000477FMedicaidGA
391018OtherGAWELLCARE
100000477EMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624001454 GA Practitioner - Anesthesiology Assistant 9032195755 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Emory University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 746-7577

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
002988GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Guardian Medical Services, LLC CurrentSince Oct 6, 2016 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Aug 1, 2021 Accepting new patients
Priority Anesthesia, LLC PastSince Jul 19, 2007 Accepting new patients
Atlanta Sports Medicine Surgery Center Past Accepting new patients

Locations

1610 Forsyth St
Macon, GA 31201
Phone (478) 743-3000

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

380 Hospital Dr
Ste 380
Macon, GA 31217
Phone (478) 746-5644

380 Hospital Dr
Ste 410
Macon, GA 31217
Phone (478) 745-1215

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

Organizations & group practices 5

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 1

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1306814249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 BELLGROVE PT",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312207621",
            "telephone_number": "478-731-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 BELLGROVE PT",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312207621",
            "telephone_number": "478-731-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CATHERINE",
        "middle_name": "D",
        "credential": "PA/AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "002988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000477C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000477G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00097133",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "580628385",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00422622",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000477F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "391018",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000477E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.