Mark E. Davis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4595 Issued in OH

Practice address

341 Youngstown Kingsville Rd SE
Vienna, OH 44473-9601

Phone

(800) 471-8592

Fax

(330) 758-5121

NPI assigned

Jun 24, 2005

Last updated

Feb 19, 2008By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vienna Medical Arts Clinic, Inc

  dba Mark E. Davis, D.O.

  • Family Medicine Physician
  • Vienna, OH
  • NPI 1639368350
  Authorized official Same address or phone
• John Balko and Associates Inc

  • Family Medicine Physician
  • Hermitage, PA
  • NPI 1932105996
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1336145309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 YOUNGSTOWN KINGSVILLE RD SE",
            "city": "VIENNA",
            "state": "OH",
            "postal_code": "444739601",
            "telephone_number": "800-471-8592",
            "fax_number": "330-758-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 YOUNGSTOWN KINGSVILLE RD SE",
            "city": "VIENNA",
            "state": "OH",
            "postal_code": "444739601",
            "telephone_number": "800-471-8592",
            "fax_number": "330-758-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARK",
        "middle_name": "E.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "4595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2056260",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0797857",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Bolchalk, RN
• Brittany Ann Burwell, DMD
• Roger Lee Clouse, D.D.S.
• Tammy Cogswell
• Daniel J. Fitzpatrick, D.O.
• Rebecca Decker
• Leslie Susan Dunlap, LMT,NMT
• Daniel J Fitzpatrick, D.O.
• Tiffany Marie Foust, MSN, FNP-C
• Angela Fox

• Family Medicine Physician in Vienna, OH
• Providers in Vienna, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.