Individual provider Active NPI

Edward R Davis, MD

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1346242203
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17187 Issued in TN
Practice address
2189 West St Ste 2
Memphis, TN 38138-3884
Phone
(901) 421-5174
NPI assigned
Aug 11, 2005
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 17187 TN
Internal Medicine Physician 207R00000X 17187 TN Primary

Addresses

Primary practice location

2189 West St Ste 2
Memphis, TN 38138-3884

Mailing address

2189 West St Ste 2
Germantown, TN 38138-3884
Phone (901) 421-5174

Other identifiers 2

IdentifierTypeStateIssuer
3068771MedicaidTN
Q003684MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100915000915 TN Practitioner - Emergency Medicine 2961527841 Reassigns benefits to 3 organizations
I20220823001416 AR Practitioner - Internal Medicine 2961527841 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Health and Medical Services LLC Internal Medicine CurrentSince Nov 15, 2021 Accepting new patients
Carr PLLC Emergency Medicine CurrentSince May 18, 2015 Accepting new patients
T M Carr MD PC Emergency Medicine CurrentSince Nov 28, 2015 Accepting new patients
Ihms Healthcare Incorporated Internal Medicine PastSince Mar 1, 2024 Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Locations

835 S Woods St
West Memphis, AR 72301
Phone (870) 733-9600

5885 Airline Rd
Unit 1017
Arlington, TN 38002

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1265 Union Ave
#8E
Memphis, TN 38104
Phone (901) 726-0999

2158 Judicial Dr
Memphis, TN 38138
Phone (901) 421-5174

2189 West St
Ste 2
Memphis, TN 38138
Phone (901) 421-5174

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Organizations & group practices 6

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1346242203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2189 WEST ST STE 2",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383884",
            "telephone_number": "901-421-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2189 WEST ST STE 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381383884",
            "telephone_number": "901-421-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EDWARD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "17187",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "17187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3068771",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q003684",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.