Jan G Davis, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

30574 Issued in CO

Practice address

1600 N Grand Ave
Suite 230
Pueblo, CO 81003-2730

Phone

(719) 595-7260

Fax

(719) 595-7265

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Pueblo Orthopedic Professional Corporation

  • Orthopaedic Surgery Physician
  • Pueblo, CO
  • NPI 1497780498
  NPD (past) Authorized official

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1316975501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 230",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032730",
            "telephone_number": "719-595-7260",
            "fax_number": "719-595-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "SUITE 230",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032730",
            "telephone_number": "719-595-7260",
            "fax_number": "719-595-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAN",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "30574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01305747",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Helen Davies, MS LAC LPCC
• Alexandria Brook Davis-Mitchell, FNP-C
• Amanda Davis, DPT
• Brian Davis
• Corinne Davis
• Jonathan David Davis, M.A., LPC
• Karen Rae Davis, FNP
• Karen Rae Davis, MA CCC-SLP
• Kathe Kristin Davis, PT
• Kayla Ranea Davis, RN

• Orthopaedic Surgery Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Orthopaedic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.