Individual provider Active NPI

Michelle Renee Davis, M.D

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1356531156
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0066002 Issued in MD
Practice address
5010 York Rd
Baltimore, MD 21212-4437
Phone
(410) 433-2200
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0066002 MD Primary

Addresses

Primary practice location

5010 York Rd
Baltimore, MD 21212-4437

Mailing address

5010 York Rd
Baltimore, MD 21212-4437
Phone (410) 433-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20080303000391 MD Practitioner - Pediatric Medicine 5890879605 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hollis Seunarine Mdpa LLC CurrentSince Nov 20, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1235 E Monument St
Baltimore, MD 21202
Phone (410) 327-5100

5010 York Rd
Baltimore, MD 21212
Phone (410) 433-2200

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": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1356531156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124437",
            "telephone_number": "410-433-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124437",
            "telephone_number": "410-433-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0066002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.