Individual provider Active NPI

William Boyce Davis, M.D.

  • Family Medicine Physician
  • Winters, CA
National Provider Identifier
1336145689
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G54959 Issued in CA
Practice address
107 Main St
Winters, CA 95694-1930
Phone
(530) 795-1110
Fax
(530) 795-1115
NPI assigned
Jun 22, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G54959 CA Primary

Addresses

Primary practice location

107 Main St
Winters, CA 95694-1930

Mailing address

107 Main St
PO Box 881
Winters, CA 95694-1930
Phone (530) 795-1110

Other identifiers 2

IdentifierTypeStateIssuer
G54959OtherCASTATE MEDICAL LICENSE
00G549590MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070426000396 CA Practitioner - Family Practice 1355447004 Practice locations: Winters, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Winters Healthcare Foundation, Inc. Family Medicine PastSince Dec 18, 2022 Accepting new patients
Winters Healthcare Foundation, Inc. PastSince Jan 19, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1336145689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MAIN ST",
            "address_2": "PO BOX 881",
            "city": "WINTERS",
            "state": "CA",
            "postal_code": "956941930",
            "telephone_number": "530-795-1110",
            "fax_number": "530-795-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MAIN ST",
            "city": "WINTERS",
            "state": "CA",
            "postal_code": "956941930",
            "telephone_number": "530-795-1110",
            "fax_number": "530-795-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "BOYCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G54959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "G54959",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G549590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winters, CA

Sources for this page

Verify at the official NPI Registry.