NPIMap

Organization Active NPI

Ashley a Davis M.D.P.C.

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1306970827
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASHLEY A DAVIS M.D.P.C.
Practice address
222 N 2ND St
Suite 204
Boise, ID 83702-6109
Phone
(208) 429-9100
Fax
(208) 429-9118
NPI assigned
Mar 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ashley A Davis, MDNPI 1437180841
Title
President
Phone
(208) 429-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

222 N 2ND St
Suite 204
Boise, ID 83702-6109

Mailing address

PO Box 44613
Boise, ID 83711-0613
Phone (208) 429-9100

Other identifiers 2

IdentifierTypeStateIssuer
000010151197OtherIDREGENCE BLUE SHIELD OF ID
8L097OtherIDBLUE CROSS OF IDAHO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050620000335 ID Part B Supplier - Clinic/Group Practice 0547204695 Receives reassigned benefits from 9 practitioners
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Locations

222 N 2nd St
Ste 204
Boise, ID 83702
Phone (208) 429-9100

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306970827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44613",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837110613",
            "telephone_number": "208-429-9100",
            "fax_number": "208-429-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 2ND ST",
            "address_2": "SUITE 204",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026109",
            "telephone_number": "208-429-9100",
            "fax_number": "208-429-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY A DAVIS M.D.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-429-9100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010151197",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8L097",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.